Immaculata University Housing Profile
2019-2020
Please complete as soon as possible after you deposit and no later than June 21st, 2019.
First Name *
Your answer
Last Name *
Your answer
Preferred Name
Your answer
Gender *
Required
Class Year (for Fall 2019 at IU) *
Required
Phone Number *
Your answer
Email *
Your answer
May we have your permission to release your phone number and e-mail address to your prospective roommate? *
Required
Do you have a medical need for special accommodations for room placement? *
Note: if you mark "yes" you will be contacted by RLH staff for supporting documentation.
Required
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service