Contact Information

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* 1. Contact Information

These characteristics define me (check all that apply):

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* 2. These characteristics define me (check all that apply):

I would prefer a roommate who is:

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* 3. I would prefer a roommate who is:

I would like the following person to be my roommate (if applicable provide first and last name):
NOTE: Both you and the person you name must make the request to be assigned to the same room.

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* 4. I would like the following person to be my roommate (if applicable provide first and last name):
NOTE: Both you and the person you name must make the request to be assigned to the same room.

My gender:

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* 5. My gender:

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