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Housing Preferences
Please fill in this form so that we can make your PBI experience as fulfilling as possible!
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* Indicates required question
Last Name:
*
Your answer
First name:
*
Your answer
Preferred pronouns
*
Your answer
Contact telephone number:
*
Your answer
Email:
*
Your answer
Please provide the name and telephone number of a person to contact in the event of an emergency:
*
Your answer
Housing
In the interest of best matching roommates and rooms, we gather the following information from each participant.
Gender
*
Your answer
Age group (select one):
*
Choose
20s
30s
40s
50s
60s
70+
Sleep times (select one):
*
Choose
Early to bed and early to rise
Early to bed and late to rise
Late to bed and early to rise
Late to bed and late to rise
Sleep type (select one):
*
Choose
heavy sleeper
light sleeper
Do you snore?
*
yes
no
Required
Do you smoke?
*
yes
no
Required
Is there someone you would like to request as a roommate?
Your answer
Do you have any physical disabilities that we should be aware of as we assign housing?
Your answer
Additional comments/requests:
Your answer
PBI Mailing List
*
I would like to receive updates about application deadlines, scholarship opportunities, course listings and other relevant updates regarding PBI (there will only be a small handful of emails send throughout the year)
I do not want to recieve these great notifications
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