1000 Victoria Park Blvd.
Davenport, FL 33896

Roommate Profile Form

Phone: (863) 256-5020
Fax: (863) 256-5021

Please complete the following online form or click here for a printable version:

Name:

Birthday:

Current Address:

City:

State:

Zip:

Daytime Telephone:

Evening Telephone:

Email Address:

Requested Roommate(s):
Move in Date:		No later than

Smoking:	I smoke I do not smoke I prefer to live in a smoke-free environment

Drinking:	I drink I do not drink I cannot drink, as I am not of age I prefer to live in an alcohol-free environment

Noise:	Other people consider me to be a quiet person Other people consider me to be an average person Other people consider me to be a loud person

Cleaning:	I prefer that the apartment be cleaned every night I prefer that the apartment be cleaned once a week I prefer that the apartment be cleaned once a semester

Cooking:	I plan to cook each night I plan to cook once a week I don’t plan to cook

Schedule:	I wake up early every morning I work full time Mon-Friday I work on weekends I am a morning person	I wake up whenever I work part-time I work nights I am a night person

Gender:	I would prefer NOT to have roommates of the opposite gender I would not mind having roommates of the opposite gender

On most weeknights I like to:	Watch TV Go out Study	Entertain Friends Listen to Music Talk on the phone

On most weekends I like to:	Watch TV Go out Study	Entertain Friends Listen to Music Talk on the phone

I would be interested in contributing the following items for general use in the apartment:	Kitchenware Electronics Decorative Items Supplemental Furniture

Although there is no guarantee that I will be matched with the perfect roommate, I understand
that Victoria Park Apartments will try their best to help in fulfilling as many requests as possible.
I guarantee the above information is true and correct to the best of my knowledge. Roommate
matching is a courtesy; Landlord does not assume liability for any roommate issues.

Victoria Park Apartments has my permission to release this information to prospective
roommates.

Name:

Apartment:

Signature:

Date:

Agent's Signature:

Date: