Roommate Form

If you are interested in sharing an apartment or house with another student(s), complete the form below and return it to the Student Affairs Office. The information will be compiled and mailed to those students who are interested and will also be posted on the Student Affairs Bulletin Board.

Fields with an * are required:

Name: *
I am interested in rooming with: *

I have an apartment or house and am
looking for roommate(s): *

I do not have an apartment or house, but am
looking for roommate(s): *

I prefer my roommate(s) to be: *

Location preference:

Pets: *

Price range:

Other preferences:
My interests are:

Current Mailing Address:
  
Address 1:
Address 2:
City:
State/Province:
Zip/Postal:
Country:
E-mail: *
Telephone Number: *
I plan to arrive in Dallas on: *
If you experience problems with this form, please contact askstudentaffairs@parkercc.edu