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Prospective Resident Questionnaire

* Indicates required field

Name *

First

Last

Email *

Phone Number *

By when are you looking to move? *

Are you currently a UTD Student? *

Yes No

What is your Age? *

Do you work? *

Yes No

Where and What do you do? *

Will you be working from Home? *

Yes No Sometimes I'm a Student

When do you wake up? *

Early Riser (6-8am) Regular Riser (8-10am) Late Riser (after 10am)

When do you usually sleep? *

Early Sleeper (9-10p) Regular Sleeper (10-11p) Late Sleeper (after 11p)

Which Meals do you prefer to eat at home? *

Breakfast Lunch Dinner

How many hours a week would you say you use the TV? *

Less than an Hour Between 1 and 7hrs More than 7hrs

How many hours a day do you spend in your room (not counting sleep)? *

Less than a couple hrs Between 2-6hrs More than 6hrs

Do you smoke? *

Yes No

Do you mind if others smoke outside? *

Yes No

Do you drink alcohol? *

Yes No

Do you mind if others drink alcohol responsibly? *

Yes No

I consider myself to be__________. *

a bit of a slob average fairly organized awesome, my game is tight!

I consider a bad roommate to be___________. *

a person who is smelly, unhygienic, and unaware somebody that consistently leaves dishes in the sink and doesn't take out the trash spoiled and entitled to 'special treatment' someone who borrows / breaks / or uses your things without permission someone who is obnoxious to your guests someone who consistently leaves laundry in the machine somebody that doesn't pay bills on time untrustworthy

I consider a Great Roommate to be__________. *

tidy and organized respectful of other people helpful on house clean up day someone who automatically takes out the trash without being asked someone who asks permission and replaces things that they borrow or use someone I can grow to call a friend

I consider myself to be__________. *

a sociopath a bad roommate a good roommate

Any talents, skills, or interest in being a House Leader? *

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