2013-2014 Moravian College Transfer Student Housing Questionnaire
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Section One - Student Information

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First Name

Last Name

Gender

Gender Male

Female

Address

Address Address:
Address 2:
City/Town:
State:
ZIP/Postal Code:
Email Address:
Phone Number:

May we share your e-mail address with a prospective roommate?

May we share your e-mail address with a prospective roommate? Yes

Program of Study

Residence Hall preference
(see http://home.moravian.edu/public/stusvc/reslife/housing.htm for more information on the residence halls)

	please select
1st choice	Residence Hall preference (see http://home.moravian.edu/public/stusvc/reslife/housing.htm for more information on the residence halls) 1st choice please select
2nd choice	2nd choice please select
3rd choice	3rd choice please select
4th choice	4th choice please select

Potential Roommate’s Name * (optional)
*requests will be honored if space allows and if both roommates list the same preference.

Potential Roommate’s Name * (optional) *requests will be honored if space allows and if both roommates list the same preference.

If space is available, would you be interested in a single occupancy room?

If space is available, would you be interested in a single occupancy room? Yes

Smoking Preference
(Although smoking is not permitted in college housing, this habit can still affect living accommodations and roommates.)

Smoking Preference (Although smoking is not permitted in college housing, this habit can still affect living accommodations and roommates.) Non-smoker

Smoker

2013-2014 Moravian College Transfer Student Housing QuestionnaireExit this registration form

Section One - Student Information

2013-2014 Moravian College Transfer Student Housing Questionnaire
Exit this registration form