Housing Preference Form - SU Abroad - Syracuse University

HOUSING PREFERENCE FORM
NAME ______________________________________
Male/Female
HOME UNIVERSITY: ________________________
SUMMER PROGRAM:_______________________________________
PLEASE INDICATE YOUR PREFERENCES BELOW:
There are 4-6 students per flat, placed in two or three separate bedrooms.
1. I prefer living in a flat that is (please note that there will be separate
bedrooms for each gender):
a. ____ single sex
b. ____ co-ed
c. ____ either single sex or co-ed
2. I prefer living in a flat with:
a. ____ my own University students
b. ____ students from other universities/colleges
c. ____ either of the above
3. I prefer a room-mate(s) who
a. ____ keep(s) late hours
b. ____ do(es) not keep late hours
4. I would describe my level of neatness as:
a. ____ high
b. ____ moderate
c. ____ low
5. I am a smoker*
a. ____ yes
b. ____ no
6. Do you have any dietary restrictions or medical issues that might affect your
needs in a flat:
a. ____ yes (please describe): ________________________________
b. ____ no
*PLEASE NOTE THERE IS A NON-SMOKING POLICY IN ALL OUR
HOUSING ACCOMMODATION AND THAT THE PUBLISHED HOUSING
RULES IN THE APARTMENTS MUST BE ADHERED TO.
continued on reverse

7. I specifically request the following roommate(s):
__________________________________________________________________
(all parties must request each other)
8. I specifically do NOT wish to be roomed with:
__________________________________________________________________
9. Please indicate if there is anything else we should know about you that will
aid us in placing you.
__________________________________________________________________
Academic Major and year:
___________________________________________________________
Other Interests:
____________________________________________________________________
Syracuse University does not discriminate on the basis of race, religion, creed, national
origin or sexual preference. Room assignments cannot be changed. Although every
effort will be made too honour individual preferences, this cannot be guaranteed.
12/2011