Required fields are marked with an asterisk (*). Your information First name* Middle name Last name* Email Address* Address City State --Select an option-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Fed St of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota No Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Africa Armed Forces Americas Armed Forces Canada Armed Forces Europe Armed Forces Middle East Armed Forces Pacific Zip Phone Number Occupation(s) 1000 characters remaining. Family information Spouse First Name Spouse Middle Name Spouse Last Name Spouse's Occupation(s) 1000 characters remaining. Name and Ages of Children Living at Home 1000 characters remaining. About you Hobbies/Interests 1000 characters remaining. Community and Civic Organizations 1000 characters remaining. International Travel or Experience 1000 characters remaining. Personal references Please provide the names and phone numbers of two personal references. First name* Middle name Last name* Phone Number* First name* Middle name Last name* Phone Number* Gender Preference Either Male Female Country of choice (1) Country of choice (2) Accept student from other country than preferred choices Yes No How many students can you accept 1 2 Available for orientation on the International Friends Program Yes No Human verification Submit
