Host Family Application

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

Mailing Address









Airport Information



First Parent












Second Parent












Additional Household Members

Please list ALL full-time household members. This includes children, other family members, and unrelated boarders/renters/acquaintances. Anyone who 18 or older is required to undergo a criminal background check
Full-Time household member








Part-time members of 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. Anyone in the home 18 or older, even part-time, is required to undergo a criminal background check.
Part-Time household member






Community Information









School Information


School Information





School Address




School Contact



Student Attendance Information







Home Environment




Required Photos
As part of your application to host, you will need to include the following pictures of your home and family. These can be uploaded here or sent electronically to acinbound@gmail.com. If you email the photos, please indicate below what photos are being sent by checking the corresponding boxes. Note: During your in-home interview, an American Councils representative may take additional photos.

Please be sure that your photos’ combined size is not more than 19MB, or the application will not send. This might lead to redoing the application. Please email your photos if you are not sure of their total size.
















Placement Information

Religious Information and preferences




Note: Students are encouraged at their pre-departure orientation to view religious institutions in the U.S. as an opportunity for cultural exchange, better understanding their host family, socializing, and as a source for volunteer opportunities. American Councils also encourages this, but it is against program policy for students to be proselytized to, make life-changing decisions (such as a change in religion), or to be "forced" to attend religious services while they are on program.

Gender Preferences


Country Preference


Living Situation

Note: This should not include a convertible bed. Inflatable mattresses, pull-out couches, and futons are considered convertible and are not allowed.














Exchange Program Participation







Family Details




Food & Diet



Examples: no pork, vegetarian, etc.

Student Expectations
Briefly describe your expectations regarding the responsibilities and behavior of the student while in your home. Note: It is against program policy for American Councils students to drive, smoke, drink alcohol, or use illegal substances while participating on their program.







Family Background






Safety





American Councils prefers that firearms are stored securely (with a lock) separately from ammunition whenever possible.


American Councils prefers that these types of medications are stored securely (with a lock) in a low-traffic area (e.g. master bedroom/bathroom) whenever possible.

Finances


The income data collected will be used solely for the purposes of ensuring that the basic needs of the exchange student(s) can be met, including three quality meals and transportation to and from school activities.


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 skiing or snowboarding).
  3. We are aware that a list of the State Department 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 1-866-790-2086 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 to 60 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.

  15. We understand that our family cannot host a student who is a relative.
  16. 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.
  17. 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.
  18. 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.
  19. 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.)
  20. 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.


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