Share America! Share your life with an International Student

Host Family Application

Student Info:

Student name

Coordinator

Community

Contact info:

Last name

Home phone

Address

City

State

Zipcode

Email

Fax

Parent Info:

Father's Name:

Father's Occupation:

Father's Phone:

Mother's Name:

Mother's Occupation:

Mother's Phone:

Children:

Name

Age

Gender

Grade/Interests

Name

Age

Gender

Grade/Interests

Name

Age

Gender

Grade/Interests

Name

Age

Gender

Grade/Interests

Living Arrangements::

Family pets

If yes, with whom?

Activities and Interests

Other

Why do you want to host an exchange student

References:

Reference Name:

Reference Phone

Reference Name:

Reference Phone