INTRODUCTIONS
This worksheet is designed to help residents living in the same space get to know each other and discuss issues
that may come up while living together. Your Resident Advisor will meet with your room or suite in four to six
weeks to complete the formal Residential Living Agreement.
(Use as many Introductions forms as necessary to accommodate all roommates.)
I.
This is Who I Am…
Roommate:
Roommate:
Roommate:
Roommate:
I am from:
I am from:
I am from:
I am from:
My mood most of the time is:
My mood most of the time is:
My mood most of the time is:
My mood most of the time is:
My biggest pet peeve is:
My biggest pet peeve is:
My biggest pet peeve is:
My biggest pet peeve is:
My idea of relaxing after being tense is:
My idea of relaxing after being tense is:
My idea of relaxing after being tense is:
My idea of relaxing after being tense is:
Something that will usually cheer me up
is:
Something that will usually cheer me up
is:
Something that will usually cheer me up
is:
Something that will usually cheer me up
is:
Please remember to complete additional agreements to accommodate all residents sharing the space.
I have the following dietary restrictions
and/or allergies:
I have the following dietary restrictions
and/or allergies:
I have the following dietary restrictions
and/or allergies:
I have the following dietary restrictions
and/or allergies:
I have shared a room before (Yes/No):
I have shared a room before (Yes/No):
I have shared a room before (Yes/No):
I have shared a room before (Yes/No):
I am ____ years old.
I am ____ years old.
I am ____ years old.
I am ____ years old.
I plan to be involved in the following
activities this year:
I plan to be involved in the following
activities this year:
I plan to be involved in the following
activities this year:
I plan to be involved in the following
activities this year:
I have a job (Yes or No) and it will affect
my time in the room by…
I have a job (Yes or No) and it will affect
my time in the room by…
I have a job (Yes or No) and it will affect
my time in the room by…
I have a job (Yes or No) and it will affect
my time in the room by…
I usually eat my meals…
I usually eat my meals…
I usually eat my meals…
I usually eat my meals…
If you would like to socialize with me,
please…
If you would like to socialize with me,
please…
If you would like to socialize with me,
please…
If you would like to socialize with me,
please…
Something else I’d like you to know:
Something else I’d like you to know:
Something else I’d like you to know:
Something else I’d like you to know:
Please remember to complete additional agreements to accommodate all residents sharing the space.
II.
Use of Each Others’ Belongings
Please indicate whether or not your roommate or suitemates may ask to borrow or use the following items. OHRL policy states that personal property is not
to be borrowed or used without the owner’s consent.
Roommate:
Roommate:
Roommate:
Roommate:
CDs/DVDs/Movies
CDs/DVDs/Movies
CDs/DVDs/Movies
CDs/DVDs/Movies
TV/DVD Player
TV/DVD Player
TV/DVD Player
TV/DVD Player
Personal Care Products (toothpaste,
shaving gel, feminine hygiene products,
etc.)
Personal Care Products (toothpaste,
shaving gel, feminine hygiene products,
etc.)
Personal Care Products (toothpaste,
shaving gel, feminine hygiene products,
etc.)
Personal Care Products (toothpaste,
shaving gel, feminine hygiene products,
etc.)
Computer and related equipment
Computer and related equipment
Computer and related equipment
Computer and related equipment
Appliances (microwave, etc.)
Appliances (microwave, etc.)
Appliances (microwave, etc.)
Appliances (microwave, etc.)
Furniture (bed, desk, chair)
Furniture (bed, desk, chair)
Furniture (bed, desk, chair)
Furniture (bed, desk, chair)
Food
Food
Food
Food
Please remember to complete additional agreements to accommodate all residents sharing the space.
If you borrow something of mine:
If you borrow something of mine:
If you borrow something of mine:
If you borrow something of mine:
Anything else others should know:
Anything else others should know:
Anything else others should know:
Anything else others should know:
III.
The Use of Our Room/Suite
Prioritize how you would use the room/suite (1=most, 3=least).
Roommate:
Roommate:
Roommate:
Roommate:
Sleeping
Sleeping
Sleeping
Sleeping
Studying
Studying
Studying
Studying
Socializing
Socializing
Socializing
Socializing
I expect to go to bed by:
I expect to go to bed by:
I expect to go to bed by:
I expect to go to bed by:
I expect to get up most mornings by:
I expect to get up most mornings by:
I expect to get up most mornings by:
I expect to get up most mornings by:
My earliest class is:
My earliest class is:
My earliest class is:
My earliest class is:
Please remember to complete additional agreements to accommodate all residents sharing the space.
Please indicate the amount of noise you prefer during the following times (i.e. I like to fall asleep with the TV on. I listen to music while studying. I like to
play my guitar when friends are over.)
Roommate:
Roommate:
Roommate:
Roommate:
Sleeping
Sleeping
Sleeping
Sleeping
Studying
Studying
Studying
Studying
Socializing
Socializing
Socializing
Socializing
I generally feel this way about noise:
I generally feel this way about noise:
I generally feel this way about noise:
I generally feel this way about noise:
I expect to get up most mornings by:
I expect to get up most mornings by:
I expect to get up most mornings by:
I expect to get up most mornings by:
My earliest class is:
My earliest class is:
My earliest class is:
My earliest class is:
Please remember to complete additional agreements to accommodate all residents sharing the space.
Please indicate how you feel about guests in the room/suite.
Roommate:
Roommate:
Roommate:
Roommate:
Guests will be allowed:
(circle your preferences)
Guests will be allowed:
(circle your preferences)
Guests will be allowed:
(circle your preferences)
Guests will be allowed:
(circle your preferences)
Anytime
Anytime
Anytime
Anytime
When I’m not trying to sleep.
When I’m not trying to sleep.
When I’m not trying to sleep.
When I’m not trying to sleep.
When I’m not trying to study.
When I’m not trying to study.
When I’m not trying to study.
When I’m not trying to study.
Other:
Other:
Other:
Other:
Guests of the opposite gender are:
(circle your preferences)
Guests of the opposite gender are:
(circle your preferences)
Guests of the opposite gender are:
(circle your preferences)
Guests of the opposite gender are:
(circle your preferences)
Okay anytime
Okay anytime
Okay anytime
Okay anytime
Okay when I’m not sleeping
Okay when I’m not sleeping
Okay when I’m not sleeping
Okay when I’m not sleeping
Okay at certain times:
Okay at certain times:
Okay at certain times:
Okay at certain times:
Not Okay
Not Okay
Not Okay
Not Okay
Guests may spend the night:
(circle your preferences)
Guests may spend the night:
(circle your preferences)
Guests may spend the night:
(circle your preferences)
Guests may spend the night:
(circle your preferences)
Anytime
Anytime
Anytime
Anytime
Only when I’ve been asked first
Only when I’ve been asked first
Only when I’ve been asked first
Only when I’ve been asked first
Never
Never
Never
Never
Other:
Other:
Other:
Other:
Remember that residents may have no more than two guests stay overnight for no more than two nights in a seven-day period. Please refer to the Resident Student Handbook for more
information.
Please remember to complete additional agreements to accommodate all residents sharing the space.
IV.
Care of Our Room/Suite
Each individual resident is responsible for cleaning up his or her individual space, items, and messes. OHRL recommends that residents create a shared cleaning
schedule or specify who is responsible for which cleaning responsibilities. Here is a list of typical cleaning items residents are responsible for:
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




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Emptying trash
Vacuuming carpet
Dusting
Washing dishes
V.
Cleaning sinks
Cleaning showers
Cleaning bathrooms (including toilets)
Doing laundry
Addressing Issues
Use this space to outline how you will address concerns with one another.
Roommate:
Roommate:
Roommate:
Roommate:
I will let you know I have a concern by:
I will let you know I have a concern by:
I will let you know I have a concern by:
I will let you know I have a concern by:
If you have a concern, please let me know
by:
If you have a concern, please let me know
by:
If you have a concern, please let me know
by:
If you have a concern, please let me know
by:
I do not like it when others communicate
their concerns by doing this to me:
I do not like it when others communicate
their concerns by doing this to me:
I do not like it when others communicate
their concerns by doing this to me:
I do not like it when others communicate
their concerns by doing this to me:
Please remember to complete additional agreements to accommodate all residents sharing the space.
VI.
Additional Comments
Use this space for any additional comments or issues that were not otherwise covered in this worksheet and suggest how you will address them. You may also
use this space to add further comments about issues that have already been discussed.
You have now had a chance to learn about each others’ lifestyles and establish some guidelines that should help you build a positive relationship. If problems do
occur, you should make an effort to solve the problems between each other using the preferences that have just been established. If you cannot settle the
matter, then utilize the resources provided by the Office of Housing and Residence Life to resolve the issues.
VII.
Conclusion
We, assigned to the same room and/or suite, enter into this agreement in good faith. We fully intend to abide by the guidelines we have outlined and
understand that we will be revisiting these topics to create our Residential Living Agreement. We agree to be flexible as we begin our time together in the
residence halls.
Resident (please print)
Signature
Date: ________________
Please remember to complete additional agreements to accommodate all residents sharing the space.