Enrollment Profile & Housing Preference Form

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* Denotes required field

Biographical Information

First Name*

Middle Name

Last Name*

Gender*

Female

Male

Birthdate*

Mailing Address:*

Country

Street

City

Region

Postal Code

Has at least one of your parent(s)/legal guardian(s) completed a bachelor's degree or higher?*

Yes

No

Academic Pursuits

Intended Major 1

Intended Major 2

Anticipated grad year

Entering Student Type

I am a first-time student

I am transferring to Houghton

I am a returning student

My anticipated grad year is:

If you are planning to graduate outside of a 4-year track, please briefly explain below

Residential Information

I will be...*

Living on Campus

Commuting

Select your housing preference

I will contact housing@houghton.edu to arrange my housing

I would like to submit a profile to be paired with a roommate

Residence Hall Preferences

Housing Preference (Requests for singles are granted pending availability and given preference to those with documented medical, academic, or other personal needs.)*

Double (regular)

Single (additional expense)

Please explain why you would like to be placed in a single. Note that priority is given to those with medical, academic or other personal needs directly related to the need for a single room.*

Please explain any physical accommodations which should be considered in your room assignment

Residence Hall Preference*

Lambein

Gillette

No Preference

Residence Hall Preference*

Rothenbuhler

Shenawana

No Preference

Name of preferred roommate (must be mutual)

Roommate Selection Information

About you: on a scale of 1 to 10, please rate yourself in each category (1 = no, 10 = yes).

I am athletic and/or enjoy athletic activities

I plan on keeping my room neat and organized

I have a strong interest or talent in music

I am generally a studious person

I am an artistic person

I enjoy doing things outdoors

I am basically an easygoing person

The equestrian program is important to me

On a weekday, I'd like
to wake up around:

6:00 AM

8:00 AM

10:00 AM

I go to bed around:

10:00 PM

Midnight

2:00 AM

I hope to get more involved in ministry opportunities

About your roommate: on a scale of 1 to 10, please rate what you would like in a potential roommate (1 = not important, 10 = very important).

I prefer a neat and organized roommate

I would like an athletically-minded roommate

I prefer a studious roommate

I prefer a roommate whose faith is ___________ to them.

I prefer a roommate who wakes up around:

6:00 AM

8:00 AM

10:00 AM

I prefer a roommate who goes to bed around:

10:00 PM

Midnight

2:00 AM

I would prefer a ministry-minded roommate

Music Preferences

I listen to the following types of music:

I do not like to listen to the following types of music:

Additional Roommate Selection Questions

What do you consider your positive qualities?

What do you consider your negative qualities?

How do you spend your free time? What are some of your interests and hobbies?

Is there any additional information you would like us to know when we consider your placement with a roommate?

Commuter Information

I will be commuting from the following address:*

Country

Street

City

Region

Postal Code

In order for you to be eligible to commute, you must be closely related to the person whose residence you are commuting from or be over 24 years of age. For more detailed information, see our residency requirements.

What is your relationship to the person living at this residence?

Family Information

Parent Marital Status:*

Married

Single

Divorced

Other

Please explain:

Houghton may contact:*

Both Parents

Mother Only

Father Only

Other

Please explain:

Mother/Guardian Information

First Name

Middle Name

Last Name

Does your mother/guardian live at the same address as you?*

Yes

No

Home Address*

Country

Street

City

Region

Postal Code

Home Phone

Cell Phone

Email Address

Company Name

Position/Title

Company Address

Country

Street

City

Region

Postal Code

Office Phone

Nature of Business

Organization/Volunteer Memberships

College/Degree (Undergraduate)

College/Degree (Graduate)

Father/Guardian Information

First Name

Middle Name

Last Name

Does your father/guardian live at the same address as you?*

Yes

No

Home Address*

Country

Street

City

Region

Postal Code

Home Phone

Cell Phone

Email Address

Company Name

Position/Title

Company Address

Country

Street

City

Region

Postal Code

Office Phone

Nature of Business

Organization/Volunteer Memberships

College/Degree (Undergraduate)

College/Degree (Graduate)

Alumni Information

How many of your immediate or extended family members have attended Houghton?*

Please list all family members that have attended Houghton and note their relationships to you (sibling, parent, grandparent, cousin, etc.):

First Name

Last Name

Relationship to you

Houghton Graduation Year

First Name

Last Name

Relationship to you

Houghton Graduation Year

First Name

Last Name

Relationship to you

Houghton Graduation Year

First Name

Last Name

Relationship to you

Houghton Graduation Year

First Name

Last Name

Relationship to you

Houghton Graduation Year

First Name

Last Name

Relationship to you

Houghton Graduation Year

Younger Sibling Information

I have __ younger siblings:

Sibling #1

Relation to you

Brother

Sister

First Name

Last Name

High School Graduation Year (YYYY)

Sibling #2

Relation to you

Brother

Sister

First Name

Last Name

High School Graduation Year (YYYY)

Sibling #3

Relation to you

Brother

Sister

First Name

Last Name

High School Graduation Year (YYYY)

Sibling #4

Relation to you

Brother

Sister

First Name

Last Name

High School Graduation Year (YYYY)

Sibling #5

Relation to you

Brother

Sister

First Name

Last Name

High School Graduation Year (YYYY)

Sibling #6

Relation to you

Brother

Sister

First Name

Last Name

High School Graduation Year (YYYY)

Enrollment Profile & Housing Preference Form

Houghton University
1 Willard Avenue
Houghton, NY 14744

+1-800-777-2556
+1-585-567-9200
admission@houghton.edu

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