Family Application for
ASA International, Crossroads
Fill out this application to let ASA International know of your interest in hosting.
Personal Information
Name
First Name:
Last Name:
Email:
Address
Street Address:
City:
State:
IN
OH
MI
Zip:
Primary Phone:
Secondary Phone:
Best time to call:
any time
Evening
Morning
Afternoon
Hosting Information
Gender Preference:
no preference
Male
Female
List all of the nationalities that may interest you
What other preferences do you have?
List three students you may be interested in hosting.
Family Information
Do you have children living at home?
Yes
No
Have you hosted before?
Yes
No
Family Interests
Check all that apply.
Soccer
Family Activities
Outdoor Activities
School Activities
Computers
Reading
Playing Instruments
Arts & Crafts
Attending concerts
Winter Sports
Board Games
Listening to Music
Watching TV
Choir
Animals
Dancing
Other Interests:
If you submit the form, an ASA International represenative will contact you soon.