Please indicate your housing preference and send this form to Logos

Name
E-mail
1) Would you enjoy living in a household with young children? Yes No
2) Do you have any religious preferences in connection with your housing accommodation? Yes No If yes, please identify:
3) Do you have any allergies? If so, please describe them.
4) Do you have any dietary restrictions? If so, please describe them.
5) Do you smoke? Yes No
6) Do you object sharing house with a person who smokes? Yes No
7) Do you mind living with pets? Yes No
8) Person (s) to be notified in case of emergency:
Name:
Address:
Phone:
Fax:
E-mail