Thomas College

Resident Student Lifestyle Questionnaire

This information form is designed to help the Student Affairs Office place new resident students with compatible roommates for the best possible living/learning environment. It is important that answers be accurate and honest. PARENTS SHOULD NOT FILL THIS FORM OUT FOR THEIR SON/DAUGHTER. ALL RESIDENCE HALLS ARE SMOKE-FREE.  GPH RESIDENCE HALL IS SMOKE-FREE AND CHEM-FREE; THERE WILL BE NO SMOKING OR DRINKING PERMITTED ANYWHERE IN THE BUILDING.

First and Last Name

Date of Birth (M/D/Y)
Major
Hometown City and State
E-mail Address:
(to receive a response)
   
Please complete the following information by selecting the appropriate choice:
   

Do you have a specific request for a roommate?
If so, please type his/her name (note, in order to be placed with this person, they must put your name down as well):

I am a:

I would like to request a:

If available, would you prefer to be placed
on a co-ed floor?

If available, would you prefer to be placed
on a quiet floor?

I am a:

I usually retire for the evening by (an average):

When I study, I need:

When I listen to music, I prefer the volume set at:

My housekeeping habits can be described as:

I prefer a room temperature that is:

I would consider myself:

I anticipate that I will:

I would enjoy a room that has:
Do you have any known allergies/concerns to be considered for housing placement?
What pets/animals do you have at home currently (please list all)?

What kind of music do you listen to the most (top three preferences):

What type of music do you prefer not to listen to/dislike:

Please list any activities/sports you are interested in:

What three words describe you best:

Please list any additional information about yourself that you think would be helpful when placing you with a roommate: