The Brentwood Apartments :: Roommate Request Form

The Brentwood
3230 County Road 10
Canandaigua, NY 14424

Tel (585) 394-8090
Fax (585) 394-9426

E-Mail The Brentwood

Roommate Preference Form

Please complete the following form to request roommate(s) or roommate assignments. Remember... the more information provided, the better we can match you with someone that has similar interests. Note that we do not assign more than one person per bedroom unless specifically requested and the tenants have a prior affiliation. (bold indicates a required field)

Full Name:
S.S.#:
E-mail:
Address:

Phone:
To assist with roommate selection as well as marketing efforts, we would appreciate you completing the following form and return it with your Apartment Lease.
Intended Major:
1st Year Student 2nd Year Student Other
When do you plan to attend? Fall Spring
Do you intend to have an automobile at the student-housing complex? Yes No
If yes, please complete:
	Make Model
	Color Plate#
Do you require special housing due to a physical impairment? Yes No
Do you have any medical conditions that we should know about? Yes No
List allergies if any:

Do you prefer? Smoking Unit Non-Smoking Unit
Please list any interests, hobbies, school activities, etc. that may help us make room assignments:
Will you participate in sports for FLCC? Yes No
If yes, which one(s)?
Would you consider yourself an: Early Riser Night Owl
How would you rate your tolerance for noise? High Medium Low
Are you a non-traditional student (over the age of 23)? Yes No
If yes, would you prefer to live with other non-traditional students? Yes No
Requested Roommates:
Did you choose The Brentwood Apartments because (check all that apply): Because of the location to the FLCC Campus? Because of the Apartment floorplan, rather than dorm style? Private Bedrooms? Parent, friend, or relative attended FLCC? Because it was recommended by Other