Roommate Request
Name
*
First Name
Last Name
Grade Completed
*
Gender
*
Male
Female
Preferred Contact Number
*
Please enter a valid phone number.
Primary Roomate Request. (This is your guaranteed roommate if they request you as well.) Name of your first roommate choice
Second Roomate Request. (This is not a guaranteed roommate but we will do our best to accommodate this request.) Name of second roommate choice
Third Roomate Request. (This is not a guaranteed roommate but We will do our best to accommodate this request.) Name of third roommate choice
Random Roomate Request (Optional) If you don't have specific requests or would be willing to have a random roommate, please check this box.
I am open to having a random roommate.
Submit
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