Sign Up to Host Students

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This is for Americans in the Wichita area to sign up to host International Students

First Name(s) *

You and your spouse

Last Name *

Address *

City *

Zip *

Primary Phone *

Type of Primary Phone *

Cell

Home

Work

Secondary Phone

Type of Secondary Phone

Cell

Home

Spouse's Cell

Work

Clear selection

Email address *

Home Church *

Pastor or Church Leader Name *

This for the purpose of obtaining a reference

Pastor or Church Leader Phone *

Pastor or Church Leader Email *

People in Home *

Please tell us about who lives in your home - how many children and ages, roommates, etc

Health of Family *

I certify that no member of my household exhibits any of the symptoms of COVID-19 as describe in www.cdc.gov

Someone in my household maybe exhibiting some of the symptoms of COVID-19 (please explain in comments section)

Accommodations *

Please tell us a bit about the area of the home the students would live in. Is it in a private area of the house or a shared area, etc.

Pets *

Please tell us about any pets you have. Are they inside or outside pets?

How many students? *

How many students would you be willing to host? - You will need a separate bed for each student

Gender Preference *

Male students

Female students

No gender preference

Transportation? *

Are you willing to host students that do not have a car?

Yes

Smoking *

Are you willing to host students that smoke OUTSIDE?

Yes

Length of Stay *

How long would you be willing to host students?

2-3 weeks until other arrangements can be made

The entire summer if needed (You will likely want to reach a rental agreement with the student.)

Other:

Health of Students *

I have been notified that International Students Inc, and Wichita State University can not guarantee the health of any students placed in my home. I assume the potential risk of inviting a student into my home who may have health challenges, including COVID-19.

Required

Disclaimer *

I understand that International Students, Inc. (ISI) and Wichita State University (WSU) are not responsible for the conduct of any student that may get placed in my home. Further, I hereby release and hold ISI and WSU harmless for any claims arising out of injury or misconduct by students placed in my home.

Required

Comments or Questions

Is there any other information that would be helpful, or do you have any questions?

Submit

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