ROOMMATE QUESTIONAIRE

Name

Email Address Cell phone

Personal Information:

□ Male □ Female

□ Single □ Married

□ Bringing Spouse/Girlfriend/Boyfriend

□ Do you mind living with someone bringing their spouse/girlfriend/boyfriend? (Check if your answer is yes)

Housing Preferences:

*Rates are quoted for Monthly charge and include furniture and utilities.

Phoenix Rate: □ $1,200 - $1,350/mo. (Private Bedroom)

□ $600 - $725/mo. (Shared Bedroom)

Austin Rate: □ $1,425/mo. (Private Bedroom)

□ $713/mo. (Shared Bedroom)

Would you be interested in adding housewares (linens/towels, bakeware/cookware/silverware, wall pictures etc.) to your apartment for an additional cost? □ $240/mo. (Private Bedroom) □ $120/mo. (Shared Bedroom)

What date are you arriving? ______

What time will you arrive? ______

What is your departure date? ______

Will you allow Oakwood to disclose your name and contact phone number to others enrolled in the Freescale Intern program? □ Yes □ No

Are you an? □ Undergraduate or □Graduate Student?

Are you bringing a pet with you? ______Breed______Weight_____

(Pets are allowed on an exception basis and fees will apply.)

Would you mind living with someone bringing a pet? □ Yes □ No

Are you bringing a car with you? □ Yes □ No

If yes, would you mind assisting with transporting roommates to and from work with you? □ Yes □ No

(If you are not bringing a car, public transportation is not guaranteed.)

Roommate Questions:

1)  Do you smoke? □ Yes □ No

2)  Do you mind rooming with someone that smokes? □Yes □No

3)  Do you drink alcohol? □ Yes □ No

4)  Do you mind rooming with someone that drinks alcohol? □Yes □No

5)  I consider myself a: □ Morning person □ Night person

6)  I am: □ Outgoing □ Quiet □ Neither

7)  I listen to: □ Alternative □ Hard Rock □ Pop □ Rap □ R&B

8)  □ Jazz □ Country □ Classical □ Gospel

9)  □ Other ______

10) Are you: □ Organized/Neat □ Messy □ Moderate

11) My top five interests (music, sports, reading, etc):

12) Is there any other quality you are looking for in a roommate?

13) Is there anything else your roommate should know about you?

14) What school are you attending?