Room and Board Questionnaire
Name: *
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): *
Sleep times (select one): *
Sleep type (select one): *
Do you snore? *
Required
Do you smoke? *
Required
Is there someone you would like to request as a roommate?
Your answer
Do you have any physical disabilities we should be aware of?
Your answer
Food
Please indicate if you are:
Do you have any food allergies?
Your answer
Do you have any dietary restrictions?
Your answer
Additional comments/requests:
Your answer
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