Incoming Freshman Placement Process Roommate Preference Questionnaire Fall 2015 YOU MAY ONLY SUBMIT THIS FORM ONCE. If you need to make changes, please contact the AMR II Housing Office at Incoming@hd.jhu.edu. Please fill out this preference questionnaire. While we try to accommodate your top selections, we cannot guarantee placement in your top choices. You will be placed in lottery number order (from lowest to highest). Your housing application will not be complete however until you submit all required documents via email, fax or mail to the AMR II Housing Office. Please Return: one signed copy of your housing contract one copy of the confirmation page that will display after you submit this form. These items are due no later than May 29, 2015 in order to be included in the freshman lottery. After submitting this form, you will receive a confirmation email to your JHU email account within 3 business days. If you DO NOT receive an email stating that we received your form, please contact the AMR II Housing Office at incoming@hd.jhu.edu. If you plan on residing at home with your parent or guardian, you must request commuter status. Please complete a Commuter Exemption Request Form by May 29, 2015 and email, fax or mail it to the AMR II Housing Office. If you have a request for special (medical) accommodations in Housing, please see the special (medical) accommodations form HERE. All special placement requests are due by May 15, 2015. Please note, this form is for roommate pairings only, we cannot utilize this information to fill a suite, and we cannot accommodate suitemate requests. *REMOVE* EMERGENCY CONTACT INFORMATION We are asking below for an EMERGENCY CONTACT PERSON (a relative or close family friend) CLOSEST TO BALTIMORE, MARYLAND (not your parent/guardian or your home address if they are more than 100 miles away). If you live within 100 miles of Baltimore, please provide your home information. In the unlikely event of a major catastrophe, natural disaster, terrorist attack, or in the event that an immediate full campus evacuation is necessary, we would like to have on record a place you can go to if home is inaccessible. This information is REQUIRED (you will need to enter it to complete the questionnaire). Please provide: Emergency contacts NAME: Emergency contacts ADDRESS: Emergency contacts HOME PHONE: Emergency contacts CELL PHONE: Emergency contacts EMAIL ADDRESS: 0 Incoming Freshman Housing Questionnaire Personal Information What is your JHED ID? (Your JHED ID was assigned to you when you set up your JHU email account. It is a combination of the first initial of your first name, all or part of your last name, and a number. i.e. "John Turner" may look like JTURNE17.). What is your birth date? (MM/DD/YYYY) Last Name: First Name: Home Phone: Student's Cell Phone: Email: All of our email communication will be sent to your Johns Hopkins email account Sex: Male Female In an effort to conserve resources, we send parent communications via email (housing and dining calendar information, move out information, housing and dining info or events). Please provide us with 2 email addresses for your parent(s) or guardian(s). Parent email 1 (Required) Parent email 2 (Optional) Please Tell us About Your Housing Preferences: Please rank your BUILDING PREFERENCES * NOTE: Indicating the same building or occupancy for more than one preference will NOT help you get that building or room type. It will only further limit our ability to place you in the order of your preferences. First Building Preference: Second Building Preference: Third Building Preference: AMR I or II Wolman McCoy Hall AMR I or II Wolman Hopkins Inn (ADD) AMR III Building A or B McCoy Hall AMR I or II Wolman AMR III Building A or B Hopkins Inn (ADD) AMR III Building A or B McCoy Hall Hopkins Inn (ADD) Please rank your OCCUPANCY CHOICE - (How many students share a bedroom) Single - 1 student in bedroom Double - 2 students sharing 1 bedroom Triple – 3 students sharing 1 bedroom First Occupancy Preference: Triple Double Single Second Occupancy Preference: Triple Double Single As we make your placement, which is of MOST importance to you: Choose One PLEASE NOTE: All of the remaining questions have DEFAULT ANSWERS. If you click SUBMIT now, your choices will be MADE FOR YOU, so read carefully! Meal Plan: Please note: All freshmen students living in the residence halls are required to participate in a meal plan. The 14 meals per week plan is the default choice. Please see the dining website here for more information. Choose One Hillel Options: These are all optional additions to your meal plan. Shabbat meals are sponsored by Hopkins Hillel and are served at the Smokler Center for Jewish Life Passover (14 meals, 2 Seders) $218.00 Shabbat Lunch Plan $280.00 Shabbat Dinner Plan $300.00 - remove Shabbat Book of Any 10 Lunches $100.00 Shabbat Book of Any 5 Lunches $50.00 All Fall Semester Holidays Plan $150.00 Gold Plan (all meals including Holidays) $650.00 I have a special dietary need and wish to have the Office of Dining Programs contact me to discuss my needs. (default is NO) No Yes Lifestyle preferences Because your lifestyle and schedule may be different in college, please try to envision yourself living IN COLLEGE when filling out this questionnaire. I clean my room: (default is weekly) Weekly I usually go to bed: (default is before 2 am) Before 2:00 am I usually get up (default is before 9 am) Before 9:00 am I like to study (default is with soft music) With soft music in the background I would like to use my room primarily for (default is for light study and light socializing) Light study and light socializing Please tell us about any special circumstances of which we need to be aware when making your placement. Are you requesting special (medical) No Yes accommodations? (default is NO) If "Yes", you must requester through the Student Disability Services office and submit medical documentation from your doctor. Please read the special (medical) accommodations website (available HERE) and submit all required paperwork no later than May 15, 2015 Athletes: Some JHU athletic teams pair teammates as roommates. If you will not be on a JHU Athletic Team, answer this question "Not an athlete". If you are a varsity athlete and you will play on more than one team, select the team for which your coach will be pairing you with a roommate. If you have questions about the person with whom your coach has paired you, contact your coach directly. Please communicate with the roommate your coach has assigned to you before submitting this questionnaire to coordinate your preferences. If you do not, we will place you based on the preferences of the student with the lower lottery number. Choose One ROOMMATE REQUESTS Do you have a special roommate request? If so, please provide the student's First, Middle and Last Name (check for accuracy and spelling) Home City and State We are not able to accept suitemate requests, only roommate requests. IMPORTANT: your potential roommate must request you as well to ensure placement together. Requests made without providing the complete and accurate name, city and state of a student may not be honored. Roommate 1 Name Roommate 1 City and State *REMOVE* EMERGENCY CONTACT PERSON (Please read explanation at top) Name Address Home Phone Cell Phone Email Address Please print TWO copies of your confirmation page. You MUST email, fax or mail one to the AMR II Housing Office along with your housing contract. Please double check your responses prior to clicking the "OK" button. REMINDER: Do not resubmit this form to change your answers. Only the first form submitted will be used. Changes can be made by contacting the AMR II Housing Office at incoming@hd.jhu.edu. PLEASE READ BEFORE YOU CLICK THE OK BUTTON: After you click the OK button, you should see a confirmation page that lists all of your choices. You can see what it looks like HERE (This link opens in a new window). If you see the confirmation page with the information you supplied, we have successfully recorded your choices. PRINT 2 COPIES of the confirmation page, one to email, fax or mail to us with your contract and one for your records.