Room Condition and Emergency Contact Report-Apartments


Welcome to the UMass Lowell Residential Community. This easy online form is how you: 

- Check into your room

- Verify the condition of your furniture 

- Complete important emergency contact information. 

Please note that existing damage or missing furniture not reported through this form when you arrive may result in charges when you move out. All students living in campus housing are required to fill out this within 24 hours of moving into a new space.

Contact Information

Apartment Complex


Date of Birth

Apartment/Room Number

Student ID Number

Damage Report

If you have damage to report, please document the current condition of each item as listed below

Door (outside, inside, and lockset)


Dresser (and drawers)

Closet/Wardrobe (and components)

Room Walls

Please indicate right, left, back and front as if you were standing in doorway looking into room


Lights (including switches)

Desk (and drawers/bookcase)

Desk Chairs

Windows (and screens)

Bed Frames


Phone and Ethernet jack

Electrical Outlets


Smoke Detectors

Common Area Report

Please inspect your Kitchen, Living Room, and Bathroom. Should any furniture be missing/damaged, please indicate that in the fields below. Be aware that by submitting this RCR form that you are responsible for any additional damages or missing items while residing in the room/suite.


Kitchen Sink





Kitchen Table/Chairs

Common Area Lights

Kitchen Floor/Ceiling/Walls

Bathroom Floor/Ceiling/Walls

Bathroom Sink/Faucet



Washer & Dryer

Living Room Floor/Carpet

Living Room Walls/Ceiling

Air Conditioner

Living Room Couch/Loveseat/Chairs

Side Tables & Coffee Table

Emergency Contact Information

Below are standard questions to identify who your contact would be in case of an emergency.

Emergency Contact Name

Emergency Contact Phone Number

Emergency Contact's Relationship to you

Your Phone Number

In the case of an emergency, do you have a place to go that is off campus?

Check into your room!

Please contact your hall staff should you have any questions. You can also contact the Office of Residence Life at, or 978-934-5160.