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If you would like to have a roommate who is a new Willamette MBA student, please complete this form and fax it to Judy O'Neill at 503-370-3011 or email it to Judy at joneill@willamette.edu by June 26. We will collect the information and email you a summary of the names, emails and preferences of students seeking a roommate so you can begin to connect with each other. Our Facebook page is also a great way to talk to your classmates about potential roommate opportunities.

CONTACT INFORMATION

First Name:

Last Name:

Current Address:

CITY, STATE, ZIP (COUNTRY):

TELEPHONE (DAY):

TELEPHONE (EVENING):

EMAIL ADDRESS:

LIVING PREFERENCES: Please mark the characteristics that best describe your living preferences

On-Campus or Off-Campus
____ I am planning to live on-campus
____ I am planning to life off-campus

Smoker/Non-Smoker
____ I am a smoker
____ I am a non-smoker
____ I prefer to live with a smoker
____ I prefer to live with a non-smoker

General Living Arrangements
____ Rent cost is most important
____ Location is most important
____ Want own room
____ Want own bathroom
____ Want more than one roommate

Study Environment
____ Prefer absolute quiet
____ Study at the library
____ Study late at night
____ Study early in the morning
____ Prefer to study with TV/Radio/Stereo, etc.

Meal Arrangements
____ Share food and expenses
____ Buy separately
____ Special diet

I give my permission for the Atkinson School to distribute my request for a roommate to other Atkinson students interested in roommate living and sharing expenses.

Signature__________________________________________________________

Date_____________________