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Bloomington-Izumi Sister City Organization Host Family Volunteer Application
I
n order to apply to host a student as part of the August 7th-16th student delegation from Izumi, please fill out the following questionnaire. Thank you for considering hosting. You should be willing to provide 3 meals a day, an appropriate place to sleep, and a ride to city hall each day. There are ten middle/ high school students and two adult chaperones.
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* Indicates required question
Contact person name
*
Your answer
cell phone number
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Your answer
E-Mail Address
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Your answer
Home Address
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Your answer
Family Description ( full names, ages, relationship)Include all people in your home
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Your answer
Pets
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Your answer
Family Activities (Hobbies, religious affiliation,Relevant Interests, etc.)
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Your answer
Describe location of extra bed.
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Your answer
Do you have any dietary restrictions? Can you accommodate a special diet?
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Your answer
Smokers In the home?
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Yes
No
Why are you interested in hosting a student?
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Your answer
Please list any relevant experience hosting international students (or being hosted by a family overseas).
Your answer
Do any members of your family have Japanese language experience? If so, provide details here. (Note that this is not a requirement for hosting!)
Your answer
Type of hosting
*
adult chaperone (2)
middle/high school student (10)
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