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Housing Proxy Form for Room Draw 2012

If you need to complete a proxy form for traditional Room Draw in April (to secure housing for the upcoming fall semester) please complete the online Proxy Form below.

ALL ROOM DRAW 2012 HOUSING PROXY FORMS MUST BE COMPLETED BY APRIL 1st, 2012.

Name *

First

Last

Goucher Email Address *

Cell Phone Number *

Gender *

Male Female

Desired House(s) *

Alcock Bacon Bennett Conner Dulaney Gallagher Gamble Hooper Jeffrey Lewis Probst Robinson Sondheim Tuttle Wagner Welsh Winslow

Select as many as apply.

Goucher ID Number *

Current Class Year *

Name(s) of desired roommate(s) *

If you identify a desired roommate, the person that you name must also indicate to Community Living that they would like to room with you.

Housing Type *

Single Sex House Single Sex Floor Single Sex Room on Co-ed Floor No Preference

Select as many as apply.

Optional Housing Alternatives *

Single Suite Double Healthy Living (application based) Language House (application based) Green House (application based) Live Music House (application based) Gaming House (application based) Peace House (application based) On Campus Apt (application based)

Select as many as apply.

Name of person serving as your Proxy *

First

Last

Please make sure that you have notified this person that you are requesting that they serve as your proxy

Email Address of person serving as your Proxy *

Submit

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Housing Proxy Form for Room Draw 2012