Housing Request Form

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Please fill out this form so that we can best house you according to your wishes.

Starred fields are required.

Year*
Session*
Name*
FirstLast
Age*
Gender*
- Male
- Female
Home School*
Email*
Address
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Phone
Fax
Please fill out the following questionnaire:
Please indicate the type of housing you prefer:*
- Apartment with other Umbra students
- Apartment with Internationals/Italians
- Homestay (may incur extra fees)
- I do not need housing; I will make my own accomodations
Do you smoke?
- Yes
- No
Would you be willing to live with a smoker?
- Yes
- No
Do you drink alcohol?
- Yes
- No
Would you be willing to live with alcohol in the apartment?
- Yes
- No
Do you have someone you would like to be roommates with?
- Yes
- No
His or her name?
Are you willing to live in a co-ed apartment? (same apartment/separate bedroom)
- Yes
- No
Do you have any health or personal needs, including food illnesses or requirements, that should be considered in your apartment assignment?*
- Yes (explain below)
- No
Please explain.
Please answer the following questions:
1) Personal Description
Please share things that would help to determine the best housing situation for you.
2) Personality/Habits
Are you messy/clean, morning/night person, active/relaxed, social/laid-back...
3) What do you enjoy doing in your free time?
Other comments regarding your housing? (optional)
Agreements*
- I understand that the Institute will attempt, but cannot guarantee, to accommodate me according to my housing requests.

Please fill out the following questionnaire: