* 1. First and last name

* 2. You are a/an...

* 3. Your address:

* 4. Please list your interests/hobbies:

* 5. What languages do you speak?

* 6. Travel or experience abroad:

* 7. How many students are you willing to host?

* 8. Your phone number (this will be given to the student):

* 9. Your email address (this will be given to the student):

* 10. Please write names and contact information for 2 personal references:

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