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Host Family Information
Please fill out this form, so we can prepare to help Ukrainian refugees. If you have any questions, please email
centermakor@gmail.com
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* Indicates required question
Your Full Name
*
Your answer
Street Address
*
Your answer
City
*
Your answer
Zipcode
*
Your answer
Is your house accessible by public transportation?
*
Yes
No
Phone Number
*
Your answer
Family email address
*
Your answer
How many people can you host?
*
Your answer
If you can host kids, what ages?
*
Your answer
Language spoken
*
Ukrainian
Russian
English
Other:
Required
Do you have pets?
*
Yes
No
Will you accept pets?
*
Yes
No
Is there anything else we need to know about your house/family?
Your answer
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