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OFFICE OF RESIDENTIAL LIFE  •  Lincoln Center

HOUSING APPLICATION (RL - 100)   |   2010 - 2011

Only students accepted to Fordham University and offered University Housing may fill out this form.
If you have not been offered housing please contact Residential Life to sign up for the Housing Waitlist.

Email: reslifelc@fordham.edu    Telephone: (212) 636-7100

• Required Field

• First Name:

Middle Initial:

• Last Name:

• FIDN: (Axxx-xx-xxx)
- -

• Street Address:

• City:

• State:

• Zip:

• Phone #:
( ) -

• Cell #:
( ) -

• Email:

• Emergency Contact Name:

• Emergency Contact Phone #:
( ) -

• Relationship:

PLEASE CHECK ALL APPROPRIATE BOXES:

FALL 2010 SPRING 2011

• Male Female Smoker* Non-smoker Willing to live with smoker Commuter Presidential Scholar Athlete	Undergraduates Incoming Freshman Sophomore Junior Senior Returning Study Abroad/USF ESL Transfer Readmitted	Undergraduates Fordham College at Lincoln Center Fordham College at Rose Hill Gabelli School of Business Fordham School of Professional and Continuing Studies N/A
		Graduate Students Law School GSRRE GSAS GSSS N/A
		Law
		Day Evening	First Year Second Year Third Year	LLM Program Amsterdam Law N/A

    * All residence halls are smoke-free.

    • GENERAL HOUSING QUESTIONNAIRE:

    For students at ANY campus. Please note, preferences cannot be guaranteed.

	I will accept housing only if my housing preference is met.
	I will accept housing whether or not my housing preference is met.

	Will you require services to accomodate a disability or medical condition?
	No	Yes (Please Explain)

1. How would you describe yourself?
Morning Person	Day Person	Night Person

2. How do you plan to use your room?
Primarily for Studying	Primarily for Socializing	Equally for Studying and Socializing

3. What amount of noise is tolerable when you are studying?
None	Light	Moderate	Heavy

4. When are your roommate's guests welcome?
Anytime	If you are consulted ahead of time	At the last minute, if they are considerate	Never

5. How would you describe your level of cleanliness?
Neat at all times	Organized but sometimes scattered	Messy

6. Please list any personal interests: (separate each interest with a comma ONLY)

Now that you have answered the 6 questions above...
Rank them in order of their importance to you in determining your ideal roommate:

	1st	2nd	3rd	4th	5th	6th
1) Is Roommate a Morning, Day, or Night Person?
2) How Roommate Plans To Use Room?
3) Amount of Noise Roommate Makes?
4) When Guests of Roommate Are Welcome?
5) Roommate's Level Of Cleanliness?
6) Your Personal Interests?

I am interested in living in a Lincoln Center triple at a reduced rate if available.

Is there another person with whom you want to live?


Name: Class Year: Please note: Your requested roommate must also list you as their roommate request for your request to be considered.

We plan to release your name, address, and phone number to your roommate(s) so you may contact each other,
and to publish contact information in the University directory. If you object to this, please check this box:

CAMPUS-SPECIFIC HOUSING QUESTIONNAIRE:

Please note, preferences cannot be guaranteed.

Lincoln Center Campus
Office of Residentail Life, Fordham University,
155 W. 60th St., McMahon Hall 108, New York, NY 10023
(212) 636-7100

For freshman and other undergraduate students ONLY; I would prefer a:

two-bedroom apartment

three-bedroom apartment

For freshman ONLY; I would prefer a:

double
triple
I am interested in being involved in Wellness Programs and Initiatives

I have read and agree to adhere to the terms of the Residence Hall Agreement available in the housing brochure.
I hereby declare that all of the information stated on this application is accurate to the best of my knowledge.

Students under the age of 18 are required to have parent/guardian verification. By checking this box you also declare that a parent/guardian has reviewed this housing application with you.

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