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Thank you for your interest in becoming a USH host! If you would like to apply for our student hosting program, please fill out the application below and we will contact you right away with further information.

Fields with an asterisk (*) are required.

Host Information  
 
First Name*
Last Name*
Host Sex*  Female  Male
DOB* / /
Format: MM/DD/YYYY
Home Address*
Home City*
Home State*
Home Postal Code*
Current Address Duration*
Primary Phone* () -
Home Phone* () -
Fax () -
Mobile () -
WorkPhone () -
Email*
Home Description*
Other People Living There
Company Name
Occupation
Referred By
Has Hosted Foreign Student*  No  Yes
Length Hosted Foreign Student
Host Foreign Languages
Host Special Interests
Do you smoke?*  No  Yes
 
Spouse Information  
 
Spouse First Name
Spouse Last Name
Spouse Sex  Female  Male
Spouse DOB / /
Format: MM/DD/YYYY
Spouse Occupation
Spouse Company Name
Spouse Work Phone () -
 
Matching Information  
 
Allow Student to Smoke?*  Yes  No  Outside
Preferred Meal Plan Option Code*

You can choose which meal service (if any) you would like to provide to students. Please pick from the following:

Room only: Student will be responsible for his or her own meals and you will not be responsible to offer any foods or prepare any meals.

Breakfast only: You are asked only to have breakfast foods available to students each morning; you need not fix the breakfast for them, but only have the foods available to them)

Room with Meals: This option includes the continental breakfast and a second meal of the day (usually dinner) which you will prepare for the students.
What Student Gender do you prefer?*  Both  Female  Male
Couple Code*  Couple  Single
Occupancy Code*

Please choose from the following options:

Double 1 Bed: You have a bedroom that can accommodate 2 students who request to share a bed (ex: two sisters attending same school)

Double 2 Bed: You have a bedroom that has two beds available for 2 students who request to share one room but with separate beds.

Single: You have a bedroom that can accommodate one student.
Will you provide a Private Bathroom?  No  Yes
Do you have Children?*  No  Yes
Do you have Pets?*
Will you provide Internet Access?*  No  Yes
AUTHORIZATION FOR BACKGROUND CHECK
By the checking the box you authorize USH to screen you for criminal and sex offenses which may confirm or deny your eligibility of hosting students in your home. You understand that USH will utilize an outside company to check such information. Furnishing all information requested is mandatory and will be maintained by USH. This authorization shall remain in effect until written notice is submitted terminating such authorization and host agreements with USH.
 
 

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