Contact Information:
Name:
Email Address:
Phone Number:
Preferred Contact Method: Phone Email No preference

Personal Information:
Gender: Male Female
Occupation: Undergrad Student Graduate Student Professional Unemployed
Birthdate: Month Day Year
Ethnicity:
Religion:
Sexual Orientation: Straight Bisexual Gay/Lesbian
Personality:   
Attach picture here:

Rental Preferences:
Neighborhood:
Ballard Belltown Capitol Hill
First Hill Fremont Green Lake
Laurelhurst Magnolia Queen Anne
Ravenna Wallingford Wedgewood
Occupancy:
Are you willing to share a bedroom? Yes No
Are you willing to share a bathroom? Yes No
Please share any preferences regarding potential roommates: (ie: gender, age, personality, etc...)

General Comments: