Dormitory Request Form

Your name:
Who would you like to room with (in order of preference)?	1. 2. 3.
I prefer:	a quiet roommate an outgoing roommate no preference
If you have any special requests, please write them here.

Please answer Yes or No:
I go to sleep early (by 11:00 p.m.)	Yes No
I am sensitive to noise	Yes No
I am sensitive to light (when I sleep)	Yes No
I have trouble getting up in the morning (Please be honest!)	Yes No
Are you taking medication regularly? If so, what type? How often?	Yes No Details:

It is common for students to bring all sorts of electrical devices with them to Israel. When shopping, please remember that Israeli appliances are 220 voltage. Note: in order to maintain an optimum Torah environment, we do not allow students to have DVD players in Yeshiva. Additionally, PSP Systems and similar devices are prohibited. We will be happy to store any such devices accidentally brought to Yeshiva until the end of the year.

(Although Yishrei Lev assumes no responsibility for any student's personal items, these lists alert us to any valuables found on campus.)
I plan on bringing with me the following items:
*Musical instrument/ equipment (ex: guitar, amp)

Yeshivat Yishrei Lev