HOST FAMILY REQUEST FORM
Mr.
Mrs.
Ms.
Miss
*FIRST NAME:
*LAST NAME:
*ADDRESS:
*CITY:
*STATE:
*ZIP CODE:
*PHONE:
When is the best time to call you?
*E-MAIL:
DO YOU HAVE ANY CHILDREN LIVING AT HOME?
NO
YES  
IF SO, WHAT ARE THEIR AGES?
WHAT IS THE NEAREST LARGE CITY OR METROPOLITAN AREA?
WHAT IS THE NAME OF THE LOCAL HIGH SCHOOL THAT THE STUDENT WOULD
ATTEND?
IN WHAT CITY/TOWN IS THE SCHOOL LOCATED?
HAVE YOU EVER HOSTED AN INTERNATIONAL EXCHANGE STUDENT BEFORE?
IF SO, WITH WHICH ORGANIZATION DID YOU HOST?
YES
NO
WHAT IS YOUR HOSTING PREFERENCE?
Male
Female
Either
FROM WHICH COUNTRY/COUNTRIES ARE YOU MOST INTERESTED IN HOSTING A
STUDENT?
Brazil
Japan
No Preference
Kyrgyzstan
China
Slovakia
Colombia
Spain
Czech Republic
Thailand
Ecuador
Ukraine
Germany
DID YOU SEE ANY STUDENTS ON OUR LIST THAT YOU MIGHT BE INTERESTED IN HOSTING?  IF
YES, PLEASE TYPE THEIR STUDENT ID NUMBERS BELOW.  MORE INFORMATION ON THE
STUDENTS WILL ONLY BE PROVIDED AFTER YOUR FAMILY HAS BEEN FULLY SCREENED AND
VETTED BY OUR ORGANIZATION.
WHAT ARE SOME ACTIVITIES THAT YOUR FAMILY PARTICIPATES IN ON A REGULAR BASIS (i.e.,
sports, music, camping, etc.)?
WHY ARE YOU INTERESTED IN HOSTING AN INTERNATIONAL EXCHANGE STUDENT?
PLEASE LIST ANY QUESTIONS OR COMMENTS THAT YOU MIGHT HAVE ABOUT HOSTING IN THE
SPACE BELOW.
Please complete the form below and a program representative will be in contact with you shortly.

* Indicates Required Information
"Promoting Cultural Awareness and Academic Excellence..."
Organization for Cultural Exchange Among Nations

2101 E. Broadway Road, Suite 4     Tempe, AZ  85282-1735
Toll-Free: 1-888-996-2326     Phone: (480) 907-7285    Fax: (480) 907-7526
E-mail:  
info@ocean-intl.org
Facebook: http://www.facebook.com/pages/Organization-for-Cultural-Exchange-Among-Nations/168874926485232