Please fill out all of the fields in the questionnaire below. For any questions, please call 970-498-0206. Please leave this field empty. The Basics Name Phone Alt Phone Email Apartment size? Choose One2 Bedroom3 Bedroom4 Bedroom I am: MaleFemale I am: Under 2121 or Older I am a smoker: YesSociallyNo I am a drinker: YesSociallyNo Grade Level Choose OneFreshmanSophomoreJuniorSeniorGradOther Study Habits Choose OneQuietLateEarlyLibraryWith MusicStudy Group Other: Major/School Describe Yourself Neatness Neat 1234 Messy I am: Choose OneOutgoing-enjoy having people over wheneverModerate-have people over, but need quiet timePrivate-prefer to not have many people over I am willing to share small items: (cd's, dishes, food, etc.) YesNoDepends I need to be left alone without intrusions: Never 12345 Always I am a: Choose OneMorning Person-Early to bed, early to riseAfternoon person-I usually roll out of bed at 2pmEvening person-I am the ultimate night owl I swear: Choose OneRarely, and it's only when I stub my toeOccasionally, including when my team is losingI would give a sailor a run for his money Other Important Information: About Me When I have a concern I: The best way to handle paying joint bills is: I think overnight guests are: My significant other visits (how often): A good roommate for me is: A bad roommate for me is: The best way to share apartment cleaning duties is: Interests/Hobbies: My "must-have" fast food restaurant is: It's OK to contact me thru Facebook: YesNo I prefer to live with Gender: Choose OneMaleFemaleCo-Ed Age: Choose OneUnder 2121 or OlderDon't Care Smokers: Choose OneYesNoSociallyDon't Care Drinkers: Choose OneYesNoSociallyDon't Care Students: Choose OneYesNoDon't Care By clicking Submit, I understand that it is the usual policy of Ram's Village to let applicants form their own living group. Because I do not have a complete group, I understand this form will be used to help assess my compatibility with other potential roommates. I understand my information will be shared with other individuals also looking for roommates. I understand and agree that Ram's Village can place me with other qualified individuals looking for roommates without prior notice. Electronically Signed by: (Name of Applicant) Date