* 1. Full Name:

* 2. Phone Number:

* 3. Email Address:

* 4. I need...

* 5. What neighborhoods are you looking to live in?

* 6. The maximum I want to spend on rent and utilities each month is:

* 7. My first preference is:

* 8. I am...

* 9. I am willing to live with a member of the opposite sex.

* 10. Guest Habits

* 11. I smoke.

* 12. I have a pet.

* 13. I did my undergraduate work at:

* 14. I am originally from:

* 15. Things a potential roommate should know about me before they call i.e. habits, hobbies.
(Anything written here will be listed with your name at your own discretion).

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