Name *

First Name

Last Name

Gender *

Male

Female

Nonbinary

Other/prefer not to say

Date of birth *

MM

DD

YYYY

Marital Status *

Married

Partnered

Single

Do you have children? *

Yes

No

If yes, do your children live at home?

Yes

No

Is there anyone else who shares your household? (E.g. other relatives, host students, or roommates): *

Yes

No

Do you have pets? *

Yes

No

What type of volunteer opportunities are you primarily interested in? *

Please select all that apply

Overnight Homestay (7-10 Days)

Overnight Homestay (1-6 Days)

Day Hosting (no overnight homestay)

Networking opportunities

Hosted Dinners (have a student over for dinner on Thanksgiving / community hosted dinner event)

Is your home near a bus stop that goes to U district

Yes

No

I'm not sure

What higher education institutions (not including UW Seattle) are you near?

Select all that apply

Seattle University

Seattle Pacific University

University of Puget Sound

Cascadia Community College

UW Bothell

UW Tacoma

Bellevue College

Edmonds College

Other

Could you accommodate more than one student at a time?

Yes

No

Are you able to accomodate a couple?

Yes

No

Are you able to accomodate a family?

Yes

No

Do you smoke?

Yes

No

Will you be willing to host a smoker if they smoke outside?

Yes

No

Reference 1

First Name

Last Name

Phone

(###)

###

####

Reference 2

First Name

Last Name

Phone

(###)

###

####

Code of Ethics Anti-Discrimination Policy *

As an organization, FIUTS does not discriminate in regard to race, color, creed, religion, national origin, gender, sexual orientation, age, marital status, or disability. Are you able to abide by this policy?

Yes

No

Code of Ethics Regarding Proselytizing *

FIUTS code of ethics requires us to clarify that surreptitious, deceptive or coercive proselytizing is unacceptable. Do you feel you could abide by this policy?

Yes

No

Do you have any expectation of an international student's participation in your household's religious activities? *

Yes

No