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On-Campus Housing Room Condition Form


Your Name:
E-mail Address:
Phone:
House:
Room:
 
Please indicate the condition of each item as either good or if repair needed, indicate what is wrong.
Item Condition
Door:
Transom:(little door at top)
Combo Lock:
Room I.D. Plate
Bulletin or White Board:
Switches:
Walls:
Ceiling:
Carpeting:
Lights:
Smoke Detector:
Closet:
Sink/Fixtures/Cabinet:
Towel Bar:
Mirror:
Medicine Cabinet:
Windows:

Furniture:
Your room should come standard with the following items. Please rate the conditions of each of these as either DAMAGED or UNDAMAGED. If any of these items are missing from your room upon check-in, please note that here as well. Also, be sure to indicate the quantity of each item.

Mattress:
Screens:
Blinds:
Heat and Air
Internet Jack:
Telephone Jack:
Telephone:
   
 
Please describe any additional problems that may exist in the room. problem. Please indicate location as applicable (e.g., hole on right wall as you face the room from doorway, etc.)
 
Please indicate any special instructions such as room combo number. Please note that due to limited time availability all rooms will be entered according to the find/fix schedule.