First Name: *

Middle Name:

Last Name: *

Social Security Number: (999-99-9999)

Address: *

City: *

State: *
–Select State– AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY

Zip Code: *

Birth Date: (MM/DD/YYYY) *

Home Phone: (999-999-9999) *

Cell Phone: (999-999-9999)

Email: *

County

Gender:
Male     
Female

Name you prefer to be called:

Semester and Year you plan to live in the halls: *
Fall
Spring

–Select YEAR– 2010 2011 2012 2013

High school graduating from:

If transfer student, college attended:

Personal Preferences

To better assist us in making roommate assignments, please answer the following questions as accurately as poosible. Please note that while we will take your preferences inot consideration, we cannot guarantee your preferences and your roomate’s preferences to be an exact match

Studying preferences: Studying is very important in the University community and different people have various situations in which they are able to concentrate at their maximum. Please choose the situation in which you are best able to study.

What Time do you prefer studying? *
–Select One– Morning Afternoon Early evening Late at night

Where do you like to study at? *
Library
In your room

Other

What type of Noise do you need when studying?
–Select One– Need background noise to study Need complete silence to study

Living Habits: I consider myself to be *
–Select One– A neat, orderly person Average in keeping my space clean Very untidy

Morning/Night Person: *
–Select One– I consider myself to be a morning person I consider myself to be a night person

I sleep…: *
–Select One– With background noise In complete silence

Thoughts about Sharing: *
–Select One– I don’t mind sharing my belongings I would like to be asked before something is borrowed I prefer not to share my things

Personal Space Scenario: *
Returning back to your room you find that your roommate has three or four friends sitting around watching TV and talking. It seems as if your roommate always has people in the room.
Your response is:
–Select One– This is very acceptable to me This situation would be fine, occasionally It would be ok if I had planned to be gone and knew ahead of time My room is my home, and I should have privacy there

Do you smoke? *
Yes
No

What do you enjoy doing in your spare time? *

What type of music do you enjoy listening to? *

Do you have any special needs that require special housing?
YES
No

You must contact the office of Disability Services at (815) 740-3204 or email ODS@stfrancis.edu for a special housing request form.The recommended deadline for submitting a special housing request form for the Fall Semester is June 1st. The final deadline for early arrivals, including athletes, is July 1st. The final deadline for all others is August 1st. The deadling for submitting a special housing request from for the Spring Semester is December 15th.

Do you have a preference to live with a specific roommate? Please list him or her below:

I would be interested in living with an International Student
YES

I am participating in the following St. Francis intercollegiate sports programs:

• Baseball
• Tennis
• Basketball
• Cross Country
• Football
• Softball
• Golf
• Volleyball
• Soccer
• Spiritline
• Track and Field

Please list extra-curricular activities, honors, and/or positions of leadership you have held below:

Duns Scotus Residential Learning Community

I am in the Duns Scotus Program and am interested in living in the Duns Scotus Residential Learning Community in Marian Hall. (Information about the Residential Learning Community and an application to become a member of it will be sent to you.)
YES

Duns Scotus Residential Learning Community for Athletes:
I also am participating in a USF SPORT, and am interested in becoming a member of the Duns Scotus Residential Learning Community regardless of whether I am housed with another athlete
YES

Paying your Housing Deposit: *
By Check
Online

Please enter your initials to affirm that all information is correct as entered, and that you understand the terms and conditions.: *