CHRISTMAS INTERNATIONAL HOUSE - ONE WEEK PROGRAM APPLICATION FORM

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Pre-Application Info (Read carefully!)

BEFORE YOU BEGIN YOUR APPLICATION you will need your student ID/class schedule and  insurance card scanned prior to beginning the application.   In addition, you will need your international student advisor's name, phone number, and email address. There will be an opportunity for you to save the application however, please remember your password so that you can finish the application.  It will take approximately 10 minutes to complete the application process (providing you already know your three location preferences). Applications will be processed beginning on September 15.

Page 1

Please type ALL information! Incomplete applications WILL NOT be processed.
Student Information





























Student Advisor Information




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Family Information
Complete this section ONLY if you are applying as a family.




















Medical Information
*Proof of medical insurance must be submitted (see Files Included with Application)




Some American host families have one or more pet animals in their home. How do you feel about staying in a home where there are pets?




Please tell us about any dietary restrictions or preferences that may affect your stay with us.



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Placement Information
*Your requested stay option may already be filled. Please indicate your choice. Our registration office will confirm availability.



*** Do not make reservations until you receive confirmation of your placement.










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Payment Method

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Terms and Conditions for Acceptance
I understand that I am expected to arrive as close as possible to the beginning date of the program and to remain as close as possible to the ending date.   Early arrivals and late departures are up to the discretion of the host and must be arranged before arrival.   Students are expected to participate in the planned activities of the program.   Students participating in a home stay program are expected to join in the daily activities of their host families/individuals.    Failure to abide by policies and requests of the host or unacceptable behavior can result in my being asked to leave the program at my expense.     If I am unable to attend, I must inform my host CIH program.   I release CIH and Atlanta Ministry with International Students, its employees, hosts, churches, volunteers, and agents from any liabilities for loss, injury, or damage to my person (family members) or property which may result from my/our participation.

By submitting this application to CIH, a program of the Atlanta Ministry with International Students, Inc. ("AMIS"), I hereby irrevocably and perpetually grant AMIS and my local CIH program to take and use photographs, video and audio recordings, or digital images of me taken in connection with my participation in the CIH program or its activities.