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YCCC Lodging Application
YCCC Lodging Application
YCCC Lodging Application
When are you looking for lodging?
Fall 2024
Spring 2025
Fall 2025
Name
First
Last
Preferred Name
Preferred Pronouns
How Do You Gender Identify?
Man
Woman
Non-Bianry
Transgender Man
Trangender Woman
Wish not to answer
Date of Birth
Month
Day
Year
Email
Phone
Present Address
Street Address
Address Line 2
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Afghanistan
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Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
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Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
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Central African Republic
Chad
Chile
China
Christmas Island
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Colombia
Comoros
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Congo, Democratic Republic of the
Cook Islands
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Croatia
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Curaçao
Cyprus
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Denmark
Djibouti
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Gabon
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Ghana
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YCCC Student ID # (OPTIONAL)
Intended Academic Program
Personality
I am very outgoing
I like to keep to myself
I am a little of both
Cleanliness
I am a very tidy person
I am more of a messy person
I more inbetween
Sleeping Habits
I am a light sleeper
I am a heavy sleeper
I’m more inbetween
Are you a smoker?
Yes
No
Medical Conditions
Yes
No
I wish to not answer
Have you ever been convicted of a crime in the USA?
Yes
No
I wish not to answer
Guests
I do not plan on having guests
I do not mind if my roommate has guests
I would prefer if my roommate did not have many guests
Roommate Preference
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