Housing Request Form

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 am attending Umbra starting in:

Please know that your answer will not be shared with anyone beyond the Umbra Housing staff.

Important Note: All roommate requests must be reciprocal or they will not be honored.

Please use both first and last names.
NoteIf you would like to live with more than one specific person, please separate each person's name with a comma.

Important Note It is forbidden to smoke in your apartment and all Umbra facilities.

(e.g., knee problems, recent surgery, celiac disease, food alergy, etc.)

Place yourself on this scale