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On Hold Request
Complete this form to formally put a child "ON HOLD" for hosting. ONLY complete this form after you have spoken with an OHHC regional coordinator about the child to determine if they are a fit for your family. Thank you for your decision to host with OHHC!
Host Family Last Name *
Your answer
Father First Name *
Your answer
Mother First Name *
Your answer
Street address *
Your answer
City *
Your answer
State (2 letter abbreviation) *
Your answer
Zip Code *
Your answer
Father's email *
Your answer
Mother's email *
Your answer
Home phone *
Your answer
Father cell phone *
Your answer
Mother cell phone *
Your answer
Country *
Child's ID # *
Your answer
My deposit ($500/child) will be sent by: *
Regional Coordinator you spoke with: *
Your answer
How did you hear about OHHC? *
Your answer
Please select one: *
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