Housing Request Form Please fill out this form so that we can best house you according to your wishes. Starred fields are required. Agreement*The Umbra Institute is a gender-inclusive institution. In order for us to provide you with the most suitable living situation possible, please complete this form. We will try to accommodate everyone to the best of our ability regardless of sex, gender, or gender identity. I agree to complete this form honestly and accurately to the best of my knowledge Legal Name* Legal First Name Legal Last Name Year*I am attending Umbra starting in:Select year2019202020212022Session*Choose a semesterFallSpringSummerAcademic Year (Fall & Spring)I'm coming with my professorI am enrolled in the following program*Food & Sustainability Studies ProgramGeneral Studies ProgramMulticultural Psychology ProgramGeneral Studies Program - Music OptionScholars ProgramDirect Enrollment – Università per Stranieri (University for Foreigners)Direct Enrollment – Università di Perugia (University of Perugia)Direct Enrollment – Accademia Belle Arti (Fine Arts Academy)I am enrolled in the following program*General Studies ProgramIntensive Italian Language through Culture ProgramI'm coming with my professorArchaeology Field SchoolAge*Home School*How did you apply to Umbra?Select a providerI applied directly to Umbra through my college/universityI applied through ArcadiaI applied through CISabroadI don't knowPlease fill out the following questionnaire:What is your sex?*MaleFemaleWhich best matches your gender identity?*MaleFemaleNon-binaryPrefer to self-describe (specify below)Prefer not to answerHow do you prefer to describe your gender identity?*Which of the following best describes your housing accommodations at your home institution?*On campusOff campusWhich best matches your situation on campus?*Shared bedroomSingle BedroomWhich best matches your situation off campus?*HomeIn an apartment/house with others (shared bedroom)In an apartment/house with others (single bedroom)Please indicate the type of housing you prefer:*Apartment with other Umbra students (the most common)Apartment with Internationals/Italians (mandatory for Intensive italian language students at Università per Stranieri))Homestay (may incur extra fees)Do you have someone with whom you would like to be roommates?*Important Note: All roommate requests must be reciprocal or they will not be honored.YesNoWhat is their name?*Please use both first and last names and not nicknames. NoteIf you would like to live with more than one specific person, please separate each person's name with a comma.Do you smoke?*Important Note It is forbidden to smoke in your apartment and all Umbra facilities.YesNoWould you be willing to live with a smoker?*YesNoEating habits: Do you prefer to be housed with:*No preferenceVegeterianGluten FreeVeganOtherEating Habits: What other dietary preference would you prefer to have considered in your housing placement?*Do you have any health conditions, physical disabilities, or personal needs that should be taken into consideration regarding your apartment assignment?*(e.g., knee problems, recent surgery, celiac disease, food alergy, etc.) NoYes (explain below)Please explain*What are your sleeping habits during the week?*I go to sleep early (before or around 11pm)I go to sleep late (after midnight)On a scale of 1-5, how extroverted/introverted are you?*Place yourself on this scale1 - Introverted2345 - ExtrovertedDo you like to have friends over at your apartment (for dinners, to hangout...)?*Maybe once a monthMaybe once a weekAt least twice a weekI host dinner at my house most nightsMy friends practically live with me but don't pay rentHow often do you plan to study?*RarelyBefore papers/exams are dueWeek nightsEvery nightEven when I sleepWhich describes your most effective study environment?*In my room alone and focusedIn the library to quietly studyIn my room with Netflix on and a friend overAt a coffee house with music and a cappuccinoIn a small groupWhich of the following best describes your cleaning habits?*Not even on my radar (when did I last do laundry?)Organized chaos (I can find my keys under this pile)OK (a few dishes and clothes here or there)Important (I make my bed daily)Very Important (You could eat off the floor)What is your level of physical activity?*1 - Not active (I prefer to spend my days with a good snack and a film)2345 - Very active (life isn't complete without a full gym membership and daily jog)Is there anything else you would like us to know about your housing preferences? (optional)Email* European Union GDPR Privacy Law ComplianceClick to read the full GDPR text as it applies to you The Umbra Institute follows all privacy regulations relative to EU and US law. GDPR Agreement* I have read and fully understand the Umbra Institute GDPR form. I accept the conditions as stated.
