Sister Cities of Greenfield Host Family Application
Email address *
Today's Date: *
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Parent(s) Names: *
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Address: *
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Telephone Numbers: *
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Name(s), age(s) and grade(s) of children in the home:
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Other family members living in the home:
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Preference for Hosting (if any): *
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Parent(s) Occupation(s): *
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Hobbies and Family Activities: *
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Please list all family pets: *
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Please tell us why you are interested in hosting a student from Kakuda, Japan: *
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By checking this box, I/we understand the responsibilities of serving as a host family and wish to be considered as an applicant to serve as a host family in the Sister City program for the 2019 traveling year. I am aware of a commitment to attend an orientation session (date to be determined). *
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By entering your name on the line below, your are effectively providing your signature, indicating that all information on this form is true and accurate to the best of your knowledge. You are also agreeing to a limited criminal history check. *
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