Princeton in Buenos Aires

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Housing Questionnaire passport-
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Please complete this questionnaire carefully. Although we cannot guarantee that your housing placement
will correspond exactly to your request; having detailed and complete information about your preferences
increases our chances of meeting your expectations. Therefore, any information, which you consider
pertinent to your needs, should be included in this questionnaire.

à Name: Gregory Magana

à Sex: M
à Date of Birth: 04/24/1995
à Place of Birth: Illinois, United States
à Studies: Computer Science
à Permanent Address: 12882 Loron Road, Morrison, IL 61270
à Email address: gmagana
à Mother’s Name: Karen Magana Occupation: Nurse
à Work-Phone Number: N/A
à Father’s Name: Alex Magana Occupation: Retired
à Work-Phone Number
à Emergency Contact: Alex Magana Telephone: 815-772-5628
à Brothers / Sisters / Ages: Sister - 17 yrs.
à Have you traveled in your country or abroad? Only in the US.
à Where?
à Do you speak Spanish? Yes
à If so, what´s your Spanish level? 200 Level
à Do you speak other languages? No

à Describe your daily habits: (circle all that apply)

a. I am an early riser. Avg. time:
b. I am a late riser. Avg. time: 10:45
c. I go to bed early. Avg. time:
d. I go to bed late. Avg. time: 3:00
e. I tend to stay in most evenings.
f. I tend to go out most evenings.
g. My weekend schedule is very different from my weekday schedule. Describe: Usually if I have
nothing to do the next morning I will stay out later than normal and, by extension, go to bed later as
well.
 h. Briefly describe your daily habits:

à I consider myself:
a. Very outgoing.
b. Somewhat outgoing.
c. Neither outgoing, nor reserved.
d. Somewhat reserved.
e. Very reserved.

à Circle all that would describe you to a host family:

a. independent; prefer not to participate in family events
b. a homebody; enjoy participating in family life
c. enjoy privacy
d. enjoy nightlife
e. adapt easily to changing situations
f. prefer organized settings
g. quiet and reflective
h. outgoing and sociable
i. neat and tidy
j. somewhat messy or messy

à Wine with dinner is very much the custom in Argentina and most Argentines drink in moderation.
Do you drink alcoholic beverages? Yes / No

à Do you actively practice a given religion and intend to practice it while in Argentina? Yes / No
If yes, religion:

à Do you have any allergies? (circle and elaborate, as applies)

pets:
food:
medication:
other:
Do you travel with an Epipen? Yes / No

à Do you have any medical conditions about which the program should be aware? Explain. Last summer
I suffered a bout with atrial fibrillation. A recurrence is a (remote and unlikely) possibility, but if it
were to happen again, I would need to be hospitalized.

à Do you observe any dietary restrictions? Elaborate. NONE

à Indicate your most preferred and least preferred foods:
Most preferred: Most conventional meats, almost all desserts, and most fruits.

Least preferred: Any vegetarian or vegan option. I am not a big fan of the vegetables.

à Please indicate a few of your preferred extra-curricular activities (e.g. sports, hobbies, etc.): I enjoy
playing pool, golfing, the occasional bit of loafing around, and other such quiet activites.
à
à Please add any other information that you would like for us to consider in your homestay application: