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Mailing Address










If you don't have a home phone, please use the primary contact's cell phone.

Airport Information



Length of Hosting


First Parent










Second Parent










Additional Household Members

Please list ALL full-time household members, in addition to the host parents listed on the previous page. This includes other family members and unrelated boarders/renters/acquaintances. Please note: Anyone who 18 or older is required to undergo a criminal background check.
Full-time household member





Part-time members of the household may include college students, nannies, other family members, seasonal boarders/renters, or anyone who frequently stays in the home and may potentially be in the home alone with the student. Please explain their part-time status below. Please note: Anyone in the home 18 or older, even part-time, is required to undergo a criminal background check.
Part-time household member





Application History



We reviewed the above referenced Host Family Application, and we verify any changes below as follows:
Family Information



Since completing your last complete Host Family Application:










Hosting Preferences

e.g. gender or country

Hosting Experience


e.g. "Marija, 2017-18, Serbia, American Councils, great experience"
Home Environment




Please note: American Councils recommends that firearms are stored securely with a lock, unloaded, and separate from ammunition whenever possible, according to best practices for firearm safety.


Please note: American Councils recommends that these types of medications are stored securely in a low-traffic area (e.g. master bedroom/bathroom) whenever possible.
School and Community Information




Personal References

Please provide four personal references from members of your community who know your family as a group and who match the description provided. Please note that an American Councils representative or local coordinator may not serve as a reference.
Non-relative who has visited you in your home






Non-relative who has visited you in your home






Community leader or school representative (non-relative) who knows your family







Relative or friend in your community (other than coordinator) able to serve as an additional support to your student






Terms

Host Family Agreement

Our family has volunteered to host a student with American Councils for International Education so that by sharing our lives with an international visitor, we may gain exposure to new ideas and perspectives and promote international friendship.


As a host family with American Councils for International Education:

  1. We will welcome our student as a member of our family and assist in our student’s adaptation to our family as well as to U.S. life and culture.
  2. We will read the American Councils Host Family Handbook and other information to be provided in our Host Family Welcome Packet to prepare for our student’s arrival, reviewing it again with our student after his/her arrival. We will become familiar with American Councils’ student rules and expectations including the list of prohibited activities (such as using a gun or other weapon) and activities that require natural parents’ permission (such as downhill skiing).
  3. We are aware that a list of the U.S. Department of State regulations for our student’s J-1 visa exchange program is available to us in American Councils’ Host Family Handbook.
  4. We will provide a safe and nurturing home environment for our student, including a bed, study area, and daily meals (three per day, which may include either lunch money or provisions for a packed lunch for school).
  5. We will ensure that our student knows how to leave his/her room and the house in the event of an emergency (such as a fire) and will explain what to do in an emergency procedure.
  6. We understand that our student has spent his or her life in a culture that may be very different from our own. We will work with our student and contact our American Councils Local Coordinator to resolve misunderstandings and to solve problems.
  7. We will help our student meet other Americans through introductions to friends, neighbors, and classmates, and by encouraging our student to join clubs or pursue activities.
  8. We will help arrange necessary transportation for our student by driving him/her, providing access to a bicycle, a bus, through rides with friends, carpooling, familiarizing him/her with public transportation, etc.
  9. We will help our student become familiar with our community and its resources such as local recreational facilities, sights, shopping areas, library, and the school she or he will be attending.
  10. We will neither allow nor encourage our student to violate American Councils policies, or the law, and will immediately report any such violation to our Local Coordinator or American Councils.
  11. We will attend any American Councils required host family events including Host Family Orientation. We will also ensure our student is able to attend any American Councils-required events, including his/her re-entry workshop in the spring and other activities.
  12. We will expect contact on a monthly basis from our Local Coordinator and will call this person if issues arise in our family’s and/or student’s adjustment, in our student’s school performance, or if our family must withdraw from the program at any point after a student placement is confirmed for us. We will also call our Local Coordinator if we have any general questions about American Councils’ programs or our hosting experience. If for any reason we are unable to reach our Local Coordinator, we will contact American Councils’ Washington, DC office at 202-833-7522 or, in emergencies, at 1-800-621-9559.
  13. We understand that someone other than our Local Coordinator will need to visit our home within 30 days of our student’s arrival to our home as required by the U.S. Department of State.
  14. We understand that visits with friends or relatives of our student, as well as most student travel, must be approved by American Councils and we will notify our Local Coordinator of these plans in accordance with the travel and visit guidelines.
  15. We understand that our student’s passport and travel documents cannot be removed from his/her possession if the student does not agree.
  16. We understand that our family cannot host a student who is a relative.
  17. We understand that in the event of adjustment issues, we are not expected to communicate directly to our student’s natural family and instead will contact American Councils if we need to communicate messages with the student’s parents. Also, if student’s communication with home becomes disruptive to the exchange experience, we should contact our local coordinator or American Councils directly.
  18. We understand that if for any reason our student needs to move out of our house, it may take two to three weeks for our Local Coordinator and American Councils to find another family.
  19. We understand that prior to our student’s departure from his/her home country he/she will be provided with information about our family, including family make up and whether the placement is permanent or temporary. He/she may also be provided with information about our family’s religious affiliations, home environment, school, and community.
  20. We will contact our Local Coordinator immediately if any information which we provided in our Host Family Application changes before our student arrives or during our student’s stay with us (i.e. if we move, if an additional person comes to live in our house, if we separate, etc.)
  21. I confirm that the information provided in my American Councils Host Family Application is true and accurate to the best of my knowledge.

We have read and understand the above guidelines and agree to follow them throughout our participation as an American Councils Host Family.