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WILLAMETTE UNIVERSITY MBA
Roommate Request Form 2009
ONLINE FORM
First Name:
*
Last Name:
*
Current Address:
*
City, State, Zip (Country):
*
Phone Number (Day):
*
Phone Number (Evening):
*
Email:
*
Living Preferences:
Please mark the preferences that best describe your living preferences.
Smoker/Non-Smoker?
I am a non-smoker
I am a smoker
I prefer to live with a non-smoker
I prefer to live with a smoker
General Living Arrangements
(Check all that apply)
Rent cost is most important
Location is most important
Want own room
Want own bathroom
Want more than one roommate
Study Environment
(Check all that apply)
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
(Check all that apply)
Share food and expenses
Buy separately
Special diet (Please Specify:
By clicking "Submit Form" below, 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.
