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Adopt a Student Program
Student Sign Up Form
If you'd like to be paired with a host family for the 2021-2022 Academic Year, please fill out the form below! We will do our best to match you with one of our awesome families.
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* Indicates required question
Name
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Hometown & state
*
Your answer
Email
*
Your answer
Phone
*
Your answer
What school do you attend?
*
Choose
Illinois College
Lincoln Land Community College
Other
What is your major or field of study?
*
Your answer
What activities are you involved in? (i.e. teams, organizations, etc.)
*
Your answer
What are your hobbies/interests?
*
Your answer
What is your favorite meal?
*
Your answer
Do you have any dietary restrictions your host family should know about?
*
Your answer
How could a host family best support you? (i.e. coming to your activities, a place to do laundry, spiritual support, help navigating Jacksonville/Central IL, etc.)
*
Your answer
Is there another student you would like to be paired with?
Your answer
Do you have any other preferences about your host family? (i.e. Pets/No Pets, Kids/No Kids)
Your answer
Submit
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