University of Nebraska Kearney

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International Education

 

INTERNATIONAL FRIENDSHIP PROGRAM 

Family Application Form 

Thank you for your hospitality!        Date:  

Name:    

Email Address:   

Home Phone:       

Cell Phone:   

Address:        

City and Zip:   

Occupation:   

Spouse's name and occupation:   

Number and ages of children:   

Single Person Family? 

      

Interests:  Check any that you enjoy and add others!

      

Other interests:   

Do you have pets?  If so, please describe:   

Travel Experience (not a prerequisite):   

Foreign Languages (if any):   

Religious/Community Groups:   

Have you participated in this program previously? 

      

If yes, how long?   

Preferences:  Country/Countries:   

I am willing to befriend a student from any country: 

      

Gender: 

      

Number of students you are willing to befriend?   

Commitment:  As a family participant in the International Friendship Program, I promise to make contact with and involve my student assignee at least twice a month for family or cultural activities. 

Signature:    Date:  

Personal Reference including phone number:   

Personal Reference including phone number: