STUDENT INFORMATION FOR HOST FAMILY PROGRAM
*First Name:
*Nationality:
*Email address:
1. What activities
would you like to
do with the Host
family?
2. Are you afraid
of pets?
(Cats/Dogs)
3. Would you like
to stay overnight
with the family?
4. Do you have
any special dietary
needs?
(Vegetarian/ Halal/
Kosher/ No Pork/
No Beef/ No
Chicken)
5. Are you willing
to cook for the
Host family?
6. Do you have
any allergies?
7. How often
would you like to
meet the Host
family?
(Provide dates:
Thanksgiving
break, Christmas
break, weekends )
Write a 3 or 4
sentences about
yourself such as
your interests,
major, or anything
else you would
like the family to
know about you.
*Last Name:
*Residence Hall:
*Phone #: