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FIUTS Visiting Program Participant Information Form

Complete this form to share important information about yourself with FIUTS program staff. **This form is not an application; it is only for students who have been accepted to a FIUTS Visiting Program. If you have not been accepted into a program, please do not fill out this form.**

First Name *

Last Name *

Preferred Name *

By what name do you prefer to be called?

Name Tag *

Please write your name (first and last) as you wish it to appear on the name tag we will provide for you during the program.

Email Address *

This should be an email that you will be checking frequently, as last-minute or urgent emails may be sent.

What is your date of birth? *

Please put your month of birth in the first field, followed by the day and year.

YYYY

What country are you from? *

What is the name of the town or city where you live?

Gender *

Female

Male

Non-binary/gender non-conforming

Prefer not to say

Prefer to self-describe (please fill in box below)

What languages do you speak? *

What knowledge, skills, and experiences are you most interested in gaining during your FIUTS program? *

If you are currently a student, what subject(s) do you study?

You will receive a program t-shirt as a souvenir of your time in Seattle. What t-shirt size would you like? *

You will stay with a local host family in the Seattle area. The following questions will help us to match you with a local host. Many Americans have pets, usually dogs and cats. During your stay with a local host, are you willing to live with a host that has a dog? *

During your stay with a local host, are you willing to live with a host family that has a cat? *

Do you have any additional comments regarding your comfort level being around pets? Please be honest - we will use this information to determine the host family that is the best match for you! Note that cats and dogs usually live inside the home and are clean and well-trained.

Do you smoke? *

Please note that smoking indoors is not permitted anywhere in Seattle.

If you do smoke, please explain more about your smoking habits.

For example; do you need to smoke frequently during the day, or are you able to go some time without smoking? As it can be somewhat challenging to find host families willing to accommodate smokers, it is important for us to understand whether you will need to smoke during your homestay.

If your host family attends religious services, they might invite you to join them. This would be a good cultural exchange opportunity. Are you interested in doing this if the opportunity arises? *

Have you ever lived, studied in, or visited the United States? If so, please describe where you visited and what you did.

Have you ever participated in a homestay before? If so, where and for how long?

Do you have any serious health conditions that we should be aware of? *

Do you have any allergies? *

If so, to what?

(For example, allergic to pollen, shellfish, peanuts, cats, dust)

Please list any treatment for allergies, if applicable.

Please select each of the items that you are able to eat below. *

I can eat poultry (chicken and turkey)

I can eat fish

I can eat beef

I can eat pork

I can eat dairy products (milk, cheese, yogurt, etc)

I can eat eggs

I CAN NOT eat any of the items listed above

I can only eat halal food

Please provide any additional information to help us understand what you can or cannot eat.

Will you need any special accommodations to practice your religion while you are in the United States? Please describe.

For example, opportunities for regular prayer, or help finding services to attend if possible.

Is there anything else you would like us to know about you that has not been addressed in this form? *

Write a personal letter of introduction to your host. Please include information about your family, your studies, your hobbies and anything else that helps describe you. The letter helps the FIUTS Homestay Specialist to match you with a host, so the more personal you make the letter, the better. *

Please write a short (3-5 sentence) biography that we can share on our website to introduce you to our community. You can share where you live, what you study, what you like to do in your free time, etc. Please also send a photo of yourself to jason@fiuts.org. *

Thank you for submitting your form. Please also send a photo of yourself to Jason Evans at jason@fiuts.org to be included in our blog post introducing participants.

Thank you for provided detailed information. The more we know about you, the better we can shape your program experience!

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Seattle, WA 98105
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Phone: +1 (206) 437-8056
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land Acknowledgement

We acknowledge that FIUTS is on unceded and traditional land of the Coast Salish, including the Duwamish People, the first people of Seattle. We honor with gratitude the land itself and those who have cared for it, past and present. FIUTS is committed to better understanding our relationship with this land and the first people of this region.