Housing Application

Anticipated Year at Kuyper (Please check one)
Initial Living Area Preference
Meal Plan Choice (required for on-campus residence)
Please answer the following questions honestly. This information is used to match you with a roommate.
Please rate yourself in the following areas: (1=very true of me; 5=not at all true of me)
Cleanliness is important to me:
Sports/Exercise is important to me:
My studies are important to me:
My faith is important to me:
Involvement on campus is important to me:
My preferred study environment is:
I would consider myself to be a:
I would like a roommate who is:
How involved do you plan to be on campus?
How involved would you like your roommate to be?
Do you smoke?
Would you be willing to room with someone who smokes?
I like to listen to music:
How many hours a week do you spend playing video games?
How many hours a day do you spend on Facebook?
Do you plan on working?
I hereby certify that the facts set forth in this document are true and complete to the best of my knowledge, and I understand that any falsified statements on this document shall be considered sufficient cause for denial or termination of residency.
Typing your name in the signature space is used to authenticate your identity as the signer of this document.