Malcolm X House Application

Area:	Malcolm-X
Last Name:
First Name:
WesID:
Class Year:
Phone or Cell:
E-Mail:
Gender Identity:
Major:
Do you smoke? (Please read the Residential Smoking Policy):	YesNo
Are you thinking about going abroad in the Spring?:	YesNoMaybe
Would you be wiling to attend at least one program a semester at another Program house?:	YesNo
I understand that as a resident of the Program House I am required to participate in house events and Program House recruitment.:	YesNo
Do you know the history of Malcolm X house and if so what are some things you know?:
Malcolm X House has a large gathering space where events occur on a regular basis. What is your expectation regarding noise levels in the house and what role do you play in creating and maintaining community standards?:
How will you contribute to making sure the house as a whole carries out the house mission?:
What goals might you have for the house, how do you want to see the house grow?:
What is one thing that you need from the other residents in order to succeed, or feel comfortable in the house? (ex. space, quiet,.....):
Are you interested in the House Manager Position?:	YesNo
If so, why?:
Thanks for filling out this application