Housing Assignment Request Form

2023-2024

Barenboim-Said Akademie gGmbH | Registrar‘s Office | registrar@barenboimsaid.de

Please submit this form to the Registrar’s Office (registrar@barenboimsaid.de) no later than 07 August
2023 for your request to be taken into consideration. Though all efforts will be made to accommodate
the requests indicated on the form, please be aware that the fulfillment of housing assignment requests is
not guaranteed, and certain requests may not be possible to fulfill. Please bear in mind that students are
assigned to an apartment for the rest of their stay in the Student Housing.

Personal Information

Name: ____________________________________________________________________________

Instrument/Study Program: ___________________________________________________________

Do you smoke?  Yes  No

(Optional) Do you have any specific dietary requirements?  Yes  No

If yes, please indicate the requirements here: ___________________________

Please indicate your preferences for the following:

1) I would like to share an apartment with someone who plays a specific instrument:
 Yes  No  No preference
If yes, please state your instrument preference(s) here: ________________________________
2) I would like to share an apartment with someone of the same gender:
 Yes  No  No preference
3) I would like to share an apartment with a non-smoker:
 Yes  No  No preference
4) I would like to request a specific Akademie student as my flatmate:
 Yes  No
If yes, please indicate the name of the student you would like to share an apartment with here:
___________________________________________________________________________

Student Signature: ______________________________ Date:____________________________