LdM Housing Request Form Housing Request Options:

LdM Housing Request Form
Please print this form, fill it out and send it back to us by e-mail.
LdM offers a free service to help students find accommodations for all campuses. Students generally live in shared
bedrooms in apartments with other students.
Student’s full name
Gender:
Current University/College:
Country of citizenship:
Date of birth(M/D/Y):
Passport Number:
Passport issued by
Passport Date of Issue:
City/State of birth:
Country of birth:
Permanent home address:
City/State:
Country:
Postal code:
Email:
Phone:
Mobile Phone:
Housing Request Options:
Check
) the desired Type of Accommodations for the appropriate term:
Campus (check one):
 Florence
 Tuscania
 Fall
 Three Cities Program
Term Request:
 FLORENCE INTERSESSION
Room Request:
 Shared Room  Single Room (Please notes below for specific campus)
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 Spring
 Rome
 JUNE
 JULY
Florence January Intersession & Three cities – Single room is not offered
Rome / Tuscania - Single room is upon a special request and according with the school availability. In the
exceptional case of a single occupancy request and assignment, the cost for single room entails an extra cost.
Please specify below the reason why it is so important for you to have a single room (I am willing to accept a double
room, at the double room cost, if my single room request cannot be met.)
Please state any request concerning roommates or any other particular needs. All requests must be made on this form.
(Students could be placed with other students from their home institution unless specifically requested otherwise).
Are you applying for a Summer Workshop or Archaeology Field School? Please specify
PRIVACY POLICY
LdM is registered to hold your personal data under the Italian data protection law. This information will be used for administrative
purposes and will not be given to any third party. I authorize the use of my personal information by Lorenzo de’ Medici, in accordance
with Italian Law D.Lgs. 196/03 on privacy
Student’s Signature:
Date:
Personal Profile Form
Please print this form, fill it out and send it back to us by e-mail.
NOTE: The LdM Housing Office will consider the preferences/requests communicated on the Personal Profile
and will make every effort to find the most compatible placement. However, the LdM Housing Office cannot
guarantee that all preferences/requests will be accommodated. Please be advised that the Cancellation Policy /
Withdrawal Policy will apply in the case of all cancellations, regardless of any reason.
Please select the box which most closely describes you
and/or your living habits:
I would describe myself as:
 Extroverted
 Introverted
 Somewhere in between
Sleeping habits:
 Early riser everyday
 Late riser everyday
 Early to bed during week and late to bed on weekends
I prefer a living environment that is:
 Relatively quiet
 Filled with constant noise or activity
 Filled with some noise, music, or activity
I read:
 All the time, recreationally as well as for class
 For class and sometimes recreationally
 I don’t like reading
I exercise or play sports:
 Regularly
 Sometimes
 Never
I usually clean dishes
 Right after I cook
 The next morning or evening
 When I need to use the dish/cooking utensil
I prefer to clean (e.g., sweep, vacuum, clean the
bathroom, etc.) my living area:
 Once a week
 Once every couple of weeks
 Once a month or less
I anticipate cooking meals at home:
 5-7 days per week
 3-4 days per week
 Rarely. I prefer to go out to eat.
When getting ready, I usually take:
 15 minutes or less
 15 minutes to hour
 More than an hour
I like to go out with friends:
 Almost every night
 Weekends only
 I usually do not go out at night
I am comfortable sharing my living space with people
of differing backgrounds and perspectives
 Yes, I am open to all.
 No. I appreciate diversity, but prefer to live with those
more similar to me.
Please Specify:
_____________________________________________
_____________________________________________
_____________________________________________
_________________________________________
If a roommate is frustrated or angry with me, I would
want him/her to:
 Tell me and speak about the issue or concern right
away
 Tell me, but give me time and space before talking
about the issue or concern
 Wait to see if the feelings subside
When I am upset, I:
 Need to discuss my feelings right away
 Need time and space to process my feelings before
talking
 Do not like to discuss my feelings with others
I would consider my study abroad budget as:
 Unlimited
 Flexible
 Limited
How often do you plan on traveling?
 Frequently (3-4 times per month)
 Occasionally (1-2 times per month)
 Rarely (a few trips during the semester)
Please select the characteristic of your ideal
roommate:
Personality:
I enjoy walking:
 A lot
 Sometimes
 Not at all
Sleeping Habits:
My ideal night out with friends is:
 Going out to dinner
 Cooking a meal at home and/or watching a movie
 Going to a club
Frequency of Travel:
Night Life:
Preferred Travel Destinations:
 Extroverted
 Introverted
 Flexible
 Early riser
 Late to bed
 Flexible
 Often
 Sometimes
 Rarely
 Often
 Sometimes
 Rarely
 Throughout Europe
 Throughout Italy
 Day trips
Please list any allergies or other medical information (i.e., anxiety, depression, eating disorder, physical disability, etc.)
that may be relevant to the housing placement process:
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Please provide any additional information regarding your personality, your expectations, your preferences, your background, or any
other information that you think could be helpful or relevant to the housing placement process:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________
Housing Waiver Form
I have read and fully agree with, accept and will abide by the conditions, rules, regulations and cancellation policy and withdrawal policy listed in
the description for LdM Housing under this link: http://www.ldminstitute.com/en/landing/housing/.
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I also understand that:
The LdM Housing Office does not guarantee that it can accommodate any/every request stated in this Housing Request Form and/or
Personal Profile. I understand that the Cancellation Policy / Withdrawal Policy stated herein will apply if I cancel or withdraw my
housing request for any reason.
I will enter my apartment ONLY at the check-in date and leave the assigned apartment no later than 12:00 noon on check-out day.
I must leave the assigned apartment in good condition.
In case damages to the apartment are found, excessive use of the utilities and/or the apartment has not been properly cleaned, the
cost will be withheld from the deposit.
LdM reserves the right to expel from the assigned apartment any student whose behavior does not conform with civilized
standards of behavior.
LdM reserves the right to withhold the transcript / Certificate of Academic Performance of students who have any type of Housing
outstanding debts.
I agree to abide by the regulations of Lorenzo de’ Medici.
By signing below, I certify that the answers I provided in the Personal Profile form and LdM application are true to the best of my
knowledge and belief.
I appoint the Lorenzo de’ Medici Institute to forward, in my name and on my behalf, my payment of the housing rent and expenses as
established and chosen in this application form.
Student’s Signature: ______________________________ Date: ____________________________________________
LDM Housing Rules
Please print this form, fill it out and send it back to us by e-mail.
 INTERSESSION ( only FLORENCE)  Spring
 Fall
1. The LdM Housing Rules are valid for the entire duration that
students’ occupy LdM apartments. The rental period begins on
housing check in and ends at 12:00 p.m. on housing check out and
may not be presumptively or tacitly extended. It is mandatory to
respect all check in dates and check out dates.
2. A Security Deposit must be paid for each Housing Reservation.
3. The housing rent balance is due no later than 30 days before the
student arrival date. If payment is not received by the deadline,
LdM reserves the right to refuse housing to students.
4. Rent and utilities are paid to the apartment Landlords. The sum
paid is based on average consumption of the utilities (water, gas,
electricity). Students will be charged for excessive use of utilities.
5. The apartments are already pre- inspected before the students’
arrival by the housing office. Any preexisting damages or
complaints must be reported in writing (on the LdM Damage Form)
to LdM Housing Coordination within 48 hours after receipt of the
keys for semester students and within 24 hours for
Summer/January Intersession students. Any items not listed on the
form will be assumed to be in satisfactory condition. Any damage to
the apartment, furnishings, electrical appliances, etc., must be
reported immediately, in writing, to the Housing Coordination office.
6. Students will be responsible for the payment of the ordinary
maintenance (light bulbs, broken keys, windows, clogged drains,
etc.). Students will be held individually responsible for damages or
violations in their assigned room and collectively responsible for
damages or violations that occur in the shared common areas of
their apartment. Students will be responsible for damage repair
costs as well as any consequences deriving from such damage.
Costs must be paid immediately. The Landlord will be responsible
for extraordinary maintenance.
7.Subletting or lending of the leased premises is expressly
forbidden. Only the undersigned lessee and assigned apartmentmates are permitted to occupy the apartment. Overnight guests are
not allowed for safety reasons and according to Italian law. Should
it be determined that there were overnight guests in the apartment,,
the Landlord and/or LdM Housing Coordination reserves the right to
evict the Student and the Dean of Students reserves the right to
impose sanctions. In accordance with the Italian law, if an overnight
guest is found in the apartment, depending on the size of the
apartment and the length of the stay, the local authorities have the
right to impose heavy fines.
8. The Landlord has the right of entry to the apartment with prior
notice (except in an emergency) to verify that the terms of the
contract are respected, to show it to future students or purchasers,
and for general maintenance.
9. The Students agree to keep the apartment, building entrance
and stairs in an orderly, safe and sanitary condition. The students
agree not to bring bikes into the apartment ‘s building, not to put
anything up on walls (with nails, tape, pushpins etc.) and not to
keep pets.
10. It is strictly forbidden to disturb neighbors in any way; to wear
heels, boots or other heavy-soled shoes or to make loud noise after
11:00 pm; to hold parties; to move or add furniture;
11. All apartments are NON-SMOKING.
12. Apartments shall be kept clean for the entire period of stay. All
apartments will be inspected after the students’ departure by the
Housing Coordinators and Landlords. Housing inspections may
take place at any other time deemed necessary by the school, with
advance notice. For semester programs, some randomly chosen
apartments will be inspected in the middle of the term. Any special
cleaning required will be charged to the students
 JUNE
 JULY
13. At departure, the apartment must be left clean, orderly, and free
of personal belongings. Neither LdM nor the Landlord will be
responsible for belongings left in the apartment after the Check-out
date.
14. The Housing Coordination office reserves the right to change
housing assignments before arrival or during the rental period (in
the latter case only for reasons such as health or other conditions
seriously affecting the general welfare of the apartment’s residents).
Students are not permitted to change housing assignment or
roommates, or to stay in another LdM housing accommodation
without receiving written permission from LdM. Such permission will
be considered only for situations involving extreme circumstances.
15. Any student who provides apartment access to non-students is
held responsible for their actions, including any violations of these
housing rules and their repercussions. LdM reserves the right to
expel from the assigned apartment any student whose behavior
does not conform to civilized standards of behavior.
16. It is necessary to double lock (deadbolt) the apartment door
when you enter and exit your apartment because in Italy the door
does not lock automatically. Always close and lock the windows
before leaving the apartment.
17. The unauthorized duplication or purchase of housing
accommodation keys is not permitted.
18. The rights of the use of keys are extended ONLY to students of
the apartment. At NO time should keys be lent out to nonresidents. Lost keys are a serious matter and not only impact the
safety of the resident who lost the key but also the safety and
security of roommates. Therefore, if the student shall be separated
from the keys to the apartment for any reason (loss, theft, lent out,
etc.); it must be reported to LdM immediately. The student alone
shall be responsible for the cost of replacement keys and the locks.
In Italy these replacements are costly.
19. Students should not write their home address on any part of
their keys or keychain.
20. Upon violation of the conditions described in the LdM Housing
Rules and LdM Family Rules, Rules of Conduct and Academic
Regulations, students will be sanctioned in accordance with the
enforcement of those Rules and Regulations.
21. No transcripts will be released for students with outstanding
debts for excessive use of utilities, apartment damages, or other
charges as mentioned above.
22. You need to be a current, active student in your courses in
order to remain in Lorenzo de’ Medici housing.
23. LdM reserves the right to evict Students from apartments based
on any violations of these Housing Rules the LdM Rules of Conduct
and or the Academic Regulations.
24. The LdM Housing Rules may be amended as LdM deems
appropriate.
25. Signing below means also acceptance of the Housing
Cancellation Policy/Withdrawal policy, and that the student is willing
to pay the designated penalty in accordance with the cancellation
policy in case of a cancellation
The signing of this document indicates acknowledgment and understanding of the LdM Housing Rules, and agreement to abide
by stated LdM Housing Coordination policies, procedures, and regulations.
Student’s full name:
Student’s Signature:
Date:
INDEPENDENT HOUSING FORM
FLORENCE INTERSESSION
 SPRING
 FALL  JUNE
 JULY
Please print this form, fill it out and send it back to us by e-mail only if you intend on finding housing outside of
LdM services
I, the undersigned :
Program:
a participant in the LDM (term)
program in (City)
, having chosen housing not through
LDM, declare to have made my own housing arrangements. I am aware that this choice automatically releases LDM
from any responsibility concerning any aspect related to my housing, including placement, disputes, and/or any other
issues. I understand that any problems regarding my housing accommodation will be dealt with exclusively by me.
I understand and agree to pay all unpaid housing debts. LDM shall be held not responsible for any refunds, claims, bills
or disputes between the student and the housing option chosen.
In agreement with the Italian Student Visa requirements, LDM is required to take action for any student behavior deemed
irresponsible.
Student’s Signature:
Date: