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Support, Disability, & Counseling Center


International Student Host Family Program - Student Application

First Name:

Last Name:








When and why did you come to the United States?

What are you planning to study here in the United States?

Do you have a car or other transportation? 

Are you afraid of, or, do you object to pets? 

Do you have any dietary restrictions (vegetarian, no pork, etc)? 

If yes, please explain:

Do you have any specific allergies?     

If yes, please list them:

Please check your preference for how often you would like to meet with your host family:

Would like to meet once a week

Would like to meet once every two weeks

Would like to meet once a month

Would like to meet less than once a month

No preference

Would you be willing to share a family with other International Students?     

What activities do you most enjoy?

If other, what?

Please write a few words about yourself and your interests?


If you have any questions please feel free to contact us at:

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