Housing Request Form - The Umbra Institute - Study Abroad in Italy

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:

Session*

I am enrolled in the following program*

General Studies Program
General Studies Program - Music Option
Food & Sustainability Studies Program
Multicultural Psychology Program
Scholars Program
Direct 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 Program
Intensive Italian Language through Culture Program
I'm coming with my own professor
Archaeology Field School

Age*

Home School*

Please fill out the following questionnaire:

What is your sex?*

Male
Female

If you would like your gender identity to be considered as part of the housing placement process, please let us know which best matches your gender identity?

How do you prefer to describe your gender identity?*

If you would like to share your pronoun preferences, please indicate them below.

Which of the following best describes your housing accommodations at your home institution?*

On campus
Off campus

Which best matches your situation on campus?*

Shared bedroom
Single Bedroom

Which best matches your situation off campus?*

Home
In 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.

Yes
No

What is their name?*

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.

Do you smoke?*

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

Yes
No

Would you be willing to live with a smoker?*

Yes
No

Eating habits: Do you prefer to be housed with*

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.)

No
Yes (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 scale

Do you like to have friends over at your apartment (for dinners, to hangout...)?*

Maybe once a month
Maybe once a week
At least twice a week
I host dinner at my house most nights
My friends practically live with me but don't pay rent

How often do you plan to study?*

Which describes your most effective study environment?*

In my room alone and focused
In the library to quietly study
In my room with Netflix on and a friend over
At a coffee house with music and a cappuccino
In a small group

Which of the following best describes your cleaning habits?*

Not even on my radar (when did I last do laundry last?)
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)
2
3
4
5 - 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*

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GDPR Agreement*

I have read and fully understand the Umbra Institute GDPR form. I accept the conditions as stated.