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Host Family Application Part 1

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Host Family App

Host Family Application Part 1

Host Family Application Part 1

Welcome to the Student Ambassador Exchange Host Family Application Form. Your privacy is very important to us. All information submitted in this application will be kept confidential. *The income data collected will be used solely for the purposes of determining that the basic needs of the exchange student can be met, including three quality meals and transportation to and from school activities. *SAE is required to run background checks on any individuals over the age of 18 living in the home with the exchange student. *This Host Family Application is for families interested in hosting on a volunteer basis. Monetary compensation is not offered for the students listed.Thank you for your understanding. If you have any questions about completing your application, don't hesitate to contact our office at info@saeglobal.org or (512) 323-9595.

Reference Information
Please list the name and email of the person who referred you to our agency, if applicable.
Indicate which level of hosting you are interested in.*
- Welcome Family - Welcomes the student for a few weeks or months
- Semester Family - Host the student for a single semester; can be fall or spring.
- School Year Family - Host the student for the full school year; typically around 10 months.
Please indicate the term in which you will be hosting.*
Is there a specific SAE student you are interested in hosting? If yes please list their name below.
Contact Information
Parent 1's Name*
First Middle Last
Parent 1's Date of Birth*
Parent 1's Phone#*
Parent 1's Email*
Parent 1's Marital Status*
- Single
- Married
Parent 1's Occupation*
Parent 1's Interests*
Parent 2's Name
First Middle Last
Parent 2's Date of Birth
Parent 2's Phone#
Parent 2's Email
Parent 2's Marital Status
- Single
- Married
Parent 2's Occupation
Parent 2's Interests
Address*
Street Address Address Line 2 City State ZIP Code
Landline Phone #
Nearest Major Airport
Please list the Full Names and Date Of Birth of other Individuals/Children living in the home.*
References Information
Please provide the name, phone number, and EMAIL ADDRESSES of TWO character references we may contact on your behalf.
References can be friends, coworkers, or neighbors... (not a relative)
Reference #1 Name & Phone Number
Reference #1 Email*
Reference #2 Name & Phone Number
Reference #2 Email*
Please upload a photo/photos of your family
Please make sure your photo is jpg format and smaller than 8MB
Drop files here or
Additional Information
How did you hear about our Student Exchange hosting program?*
Have you or your family participated in an exchange program before?*
- Yes
- No
If yes, please provide information on the organization you hosted through.
What languages are spoken in your home?*
Would the family be willing to provide special transportation for the student for extracurricular activities if required in the afternoon or evening?*
- Yes
- No
Average Annual Income Range (The income data collected will be used solely for the purposes of ensuring that the basic needs of the exchange students can be met, including three quality meals and transportation to and from school activites.)*
- Less than $25,000
- $25,000-$35,000
- $35,000-$45,000
- $45,000-$55,000
- $55,000-$65,000
- $65,000-$75,000
- $75,000 and above
Would you provide three quality, square meals daily?*
- Yes
- No
Does anyone residing in the home receive any kind of public assistance (financial need-based government subsidies for food or housing)?*
- Yes
- No
If yes, please explain.
What personal expenses would you expect a student to pay for?*
Has anyone in your family ever been charged with a crime?*
- Yes
- No
If yes, please explain.
Signatures
I verify that the information submitted in the form is correct to the best of my knowledge. We acknowledge that before releasing student information to me, Student ambassador exchange may run a background check, to ensure the safety and security of student information.
Parent 1's Electronic Signature*
By typing my name, I agree to the above statement.
Date*
Parent 2's Electronic Signature
By typing my name, I agree to the above statement.
Date
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We would love to hear from you! Please fill out this form and we will get in touch with you shortly.

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Student Ambassador Exchange is a 501(c)3 non-profit organization designated by the State Department to conduct and encourage inter-cultural exchange programs. Our aim is to increase dialogue between cultures, share new experiences, and make long lasting ties of friendship through public diplomacy.

*Unless otherwise noted, the students appearing in the photographs on this site are not eligible for hosting or are stock images.

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Contact HQ

(512) 323-9595 – Main Phone

info@saeglobal.org

Contact SAE Staff

Program & Outreach Coordinator – Diedra Connolly

(512) 323-9595 ext. 3040

diedra@gwca.org

Emergency Phone

(512) 323-9595

Contact HQ

(512) 323-9595 – Main Phone

info@saeglobal.org

Contact SAE Staff

Program & Outreach Coordinator – Diedra Connolly

(512) 323-9595 ext. 3040

diedra@gwca.org

Emergency Phone

(512) 323-9595

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