Hawaii FSC Roommate Asssistance Request Form

Fill in the information below and either:
  - email it to uscc_roommate@hawaiifsc.org
or
  - mail it to  Hawaii FSC
                1165 Kukila Street
                Honolulu, HI 96818

This information will be included in the list of potential roommates that will be sent to all participants in this list (and only to list participants).   Those items marked with asterisk (*) must be included in the list of potential roommates.  Other items are optional.  

You must provide your name for verification of US Figure Skating membership; please indicate whether you want your name to be included in the published list.  Your U.S. Figure Skating membership number is also required; it will NOT be included in the list.

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Name (as listed in U.S. Figure Skating membership):

Include name in list (yes/no):

U.S. Figure Skating membership number (will NOT be included in list):

* Email Address:

* Gender:

* Planned arrival date:

* Planned departure date:

* Desired number of people in room (2 or 4):

* Desired type of room:
  (Moderate Hotel, Superior Studio w/K, or Deluxe Studio w/K)

* Smoking status (smoking, non-smoking or no preference):

College or university:

Age:

Competition Level:

Comments or other info: