DIVISION OF SPANISH AND PORTUGUESE
NW CADIZ Program, Spring 2016
=========
Housing Preference Form

Please use the following form to indicate your housing preferences. In recent years all our students have chosen to live with families. If you have a very strong preference for a residence hall (dorm), please contact the director right away, as it takes time to locate a viable residence hall situation. The program's administrators make every effort to comply with each student's preference; however, no guarantees are made, since it is not always possible to give every member of the group the exact sort of housing arrangement that he or she prefers.

Please download, fill in, and save the form and send it electronically as a word document to petersen@u.washington.edu, AFTER the second of the two obligatory orientation meetings .

NAME	EMAIL ADDRESS
AGE	Year-long students ____ (check)
SEX

In a private home: I would prefer (answer YES, NO or DOESN'T MATTER):
    a. house with young children
    b. house with children my age
    c. house with no children
    d. no pets
    e. a non-smoking house
      Circle one: I myself a) occasionally, b) never, c) do   smoke.

Do you have a medical condition that requires special attention? If so, please describe.

Do you have any dietary restrictions? Please list:

Do you have any allergies? Please list:

Special interests or hobbies? Describe:

Any other considerations we should take into account or your housing assignment?

In the event we can not satisfy all your wishes, please prioritize your preferences: (e.g.? 1st: non-smoking; 2nd: part of town; 3rd family with children; or 1st: vegetarian enabled; 2nd: near my friend, ?3rd: sibliings my age --something like that)?