Student Application

Provide the requested information on the on-line form and email to International Friends. If you do not yet have all of the information, please send the form with the information you do have. Then send the rest of the information as soon as it is available. There is no cost to participate.
Fields marked with an asterisk * are required.
Family Name  * 
First Name * 
Sex (M/F) * 
Cleveland Address * 
 
City
Zip Code * 
Home Country, State or Province
Previous degree(s)
Email Address * 
Phone * 
Lab or Office Phone
Marital Status Married, spouse is with me  Married, spouse is in home country   Single
University Name
Degree Program Bachelor  Masters  PhD Post Doc
Have you had a host family in the past? If so, describe briefly
 
What would you like most about getting to know an American family?
 
List some of your hobbies and family interests:
 
Do you own a Car? Yes  No
Do you smoke? Yes  No
Do you have any food restrictions?
  (example: Vegetarian)		 Yes  No
list any food allergies, restrictions or prohibitions:
Do you have any allergies to dogs or cats? Yes  No

                                     
Tom and Joan Wright, International Friends   .  PO BOX 93914, Cleveland, OH 44101-5914   .  440-884-1177