My Living Preferences
8. I like to have friends call:
1. I like my room to be kept:
a. Neat
b. In between
c. Messy
2. I like my room cleaned:
a. Daily
b. Weekly
c. Monthly
d. As needed:___________________
3. To maintain a clean and neat room, I do the
following:
a. Do laundry before the basket
overflows
b. Wash dishes after using them
c. Take out trash/recycling once per
week
d. Vacuum/Dust once a week
e. Make beds daily
4. I prefer the windows to be:
a. Open
b. Closed
c. Depends on the weather
d. Depends on the time of day
e. No preference
5. The time I most prefer to study is:
a. Morning (9am-noon)
b. Afternoon (Noon-5pm)
c. Evening (5pm-10am)
d. Late evening (10pm-Midnight)
e. Late night (Midnight-9am)
6. When I study in the room, I prefer
someone else to be:
a. Completely quiet
b. Have low music/headphones
c. Use the T.V.
7. When I have other people over to study
with me, I prefer my roommate to:
a. Not be in the room
b. Remain in the room but quiet
c. Other: ________________
a. After 11pm: Yes No
b. Before 8a.m.: Yes No
9. I am okay with the following personal
belongings being used by my roommate
(please circle):
Television, Stereo, Microwave, Refrigerator,
Food/Drink, Computer, Game System,
Clothes, Personal Items, Other:__________
10. I would like any messages given to me:
a. Within 24 hours
b. Within 48 hours
c. Other: _______________
11. I prefer to go to bed at the following time:
a. 10:00pm-11:30pm
b. 11:30pm-1:00am
c. 1:00am-3:00am
d. Other:____________________
12. When I am sleeping, it is okay for someone
else to (circle those that are okay):
Watch TV, Listen to music, Use the hair dryer,
Have guests, Have the main light on,
Use a desk light, Other:___________
13. If my roommate has an overnight guest of
the same sex, they should arrange to do so
__________ days/weeks in advance.
14. Guests of my roommate in our room are
allowed to (please circle):
Sit/use my bed, Eat my food,
Use personal belongings, Use my computer,
Other: ______________________
15. If 21 or older, I want the room to be
alcohol-free: (Circle) Yes No
16. When I need personal time, I….(fill in):
17. If there is a conflict, I prefer to be
approached by: