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 Home-Stay Volunteer

   
   
Thank you for your interest in the Home-Stay Volunteer program. Please fill out the following form:
What is it? A program that seeks volunteers to become hosts for international business professionals and nonprofit leaders engaged in short term training programs.
How long do the participants stay with me? The average stay varies from 8 days to 4 and 1/2 weeks 
Where is it? Heartland International is based in downtown Chicago, but we seek home-stay volunteers from the city AND the suburbs.
Why do I want to be a host?

Expose yourself to new world views & culture

Make new friendships!

Improve foreign language skills!

Participate in a unique intercultural experience!

First Name:

Last Name:
Home Address:
Address cont.
City:
State: IL
Zip Code:
Home Phone:

Business Information

Employer:
Occupation:
Work Address:
Address (cont.):
City:
State:  
Zip:
Phone:
Fax:

Email:

Date of Birth:

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Sex:

MaleFemale

Foreign Languages spoken in the household:

Children at Home: Name: Age:

Name: Age:

Other Adults in Household: Name:   Occupation:

Name: Occupation:

Type of Residence: Apartment Condominium House Other
Type of Accommodation for guest: Guest room      Other
Are there pets in your home? No     Yes,
Do any household members smoke? No     Yes
Preference, if any Male     Female     Non-smoker
What interests you in hosting a foreign professional:
What Activities do you and other members of the household enjoy doing together:
Do you or other members of the household observe a specific diet? Do you and other members of the household have common, regularly scheduled meals?
Where is the nearest bus stop or train station (in blocks):
From your home, via public transportation, how would your guest reach Michigan and Lake?
Other Comments:
Program Availability: Any Time Near Future I can't volunteer now, but I am interested in future opportunities.