CARSON-NEWMAN UNIVERSITY
Appalachian Commons | Room Condition Report
This form is to be completed within 24 hours of receiving a room key and/or moving into a residence hall room. Failure to complete and submit a Room Condition Report within 24 hours will result in a fine of $25 and will require payment for any damages incurred during the duration of stay, at the discretion of Residence Life.
Student ID#
*
Last Name
*
First Name
*
Cell Phone #
*
C-N E-mail
*
Which building do you live in?
*
Please Select
LeConte (Men's)
Greenbrier (Women's)
Which floor do you live on?
*
Please Select
1st Floor
2nd Floor
3rd Floor
Apartment Complex Number
*
Look above outside door
Apartment Key Number
Key to the front door of the apartment, may include letters and numbers
Room Key Number
Key to your personal room, may include letters and numbers
Room Letter
*
A
B
C
D
Personal Room
Doors
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Door Lock/Knob
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Ceiling
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Walls
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Floor
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Light Switches
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Outlets/Jacks
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Windows
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Screen(s)
*
Excellent
Good
Fair
Repair
No Screen
If you selected Fair or Repair, please explain:
Blinds
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Mattress
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Wardrobe/Dresser
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Desk
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Desk Chair
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Air Conditioner/Heater
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Smoke Detector
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Air Vent
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Common Space
Living Room, Kitchen and Bathroom(s)
Bathroom(s) Shower(s)
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Bathroom(s) Toilet(s)
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Bathroom(s) Cabinet(s)
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Bathroom(s) Light Fixture(s)
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Bathroom(s) Mirror(s)
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Common Space Base boards
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Common Space Air Vent(s)
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Thermostat
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Common Space Walls
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Common Space Window
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Refridgerator
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Kitchen Light Fixture
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Kitchen Cabinets/Drawers
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Stove
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Kitchen Counters
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Carpet
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Kitchen and Bathroom(s) Floors
*
Excellent
Good
Fair
Repair
If you selected Fair or Repair, please explain:
Common Space Furniture
Write what furniture you have, the quantity and condition
Repair Comments
Be as precise and detailed as possible
This form is to ensure that each roommate takes equal responsibility in the cleaning of the common spaces regardless of who moves out first. Any damages or cleaning fees assessed will be split equally among all room occupants.BY SUBMITTING THIS FORM, I certify that I understand that I am responsible for following the rules and regulations stated in the Guide to Residence Life which is available at www.cn.edu/reslifeguide, and that I have received my room key. By signing my name, I accept the current condition of the room and the responsibility for maintaining it as described on this report. Furthermore, I attest that the items noted were in the condition(s) specified above. I understand that I will be held financially responsible for all damages done to this room that are not specified above. I understand that, just as I checked in to the residence hall, I must setup an appointment with a C-N Residence Life staff member to check-out.
Student Signature
*
Submit
Should be Empty: