NameDate MM slash DD slash YYYY Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail AgeGender Male Female Non-Binary Please answer the following:1. Roomate Preference Male Female Non-Binary No Preference 2. Monthly Rent Price Range3. Type of housing you prefer. Apartment House Either 4. Location Preference Tacoma University Place Lakewood Puyallup No Preference 5. When will you be moving to the area?6. Do you/will you have your own car? Yes No 7. Would you be interested in carpooling? Yes No 8. Do You prefer your own bedroom Yes I am willing to share a bedroom. 9. Do you/will you have a non-NCAD student living with you? Yes No 10. If Yes, then who? Name and Relationship:11. Do you smoke or vape? Yes No 12. Do you mind if your roommate smokes? Yes No 13. Do you own pets that you plan to have live with you? Yes No 14. If Yes, then type of pets?15. Is this your first time renting an apartment? Yes No 16. How many roommates would you prefer to live with?PERSONALITY QUESTIONS:17. Are you messy, tidy, or in-between? 1 (Tidy) 2 3 4 5 6 7 8 9 10 (Messy) 18. Are you a morning person or night person? Morning Night 19. Are you introverted or extroverted? Introverted Extroverted 20. Do you go to bed early or late? Early Late 21. What are some of your favorite at home past times (i.e., reading, watching T.V.)?22. List any specific traits you hope to find in a roommate:23. List anything else you wish a potential roommate to know about you:DISCLAIMER:NCAD offers roommate connection assistance only as a service to the student. NCAD does not guarantee roommate compatibility. By signing below, the applicant hereby releases and discharges Art Center, Inc dba Northwest College of Art & Design, its officers, directors, and employees and shall hold and save each harmless from any and all actions, claims, demands, liabilities, losses or expenses of any kind which may result by reason of student’s request for roommate connection assistance.Consent:(Required) I authorize NCAD to release the info listed above to other NCAD students who may be looking for a roommate. If you have any questions or concerns regarding this form please contact us by clicking here.
