1. Your name

2. Street address

3. City

4. State

5. Zip Code

6. Email address

7. Best phone number to contact you

8. Which country would you prefer to host a Chaperone from?

9. Would you prefer Male, Female or Either?

10. Which age range would work best for your family? (select all that apply)

11. What is your work schedule?

12. How many hours a week will at least one spouse be home?

13. Are you willing to drive your chaperone to meet host families for day outings if necessary?  (You would not be required to stay for the day - just drive to a meeting place.)

14. What are your interests and/or hobbies?

15. How many children do you have in your home?

16. Are any foreign languages spoken in your home?

17. Have you hosted a child, chaperone or exchange student in the past?

18. Do you have good cell phone/internet coverage in your home?

19. Additional Comments

20. May we share your email address with the chaperon you are hosting? Some like to contact you ahead of hosting via email.

Please email a picture of the outside of your home and of your family to khannon@nhfc.org. These do not need to be anything special - just some quick pictures to help our chaperons get an idea of where and with whom they are staying. This helps so much with their nervousness - especially when it is their first trip to America. Thank you!