Sister Cities Homestay Host Profile Form

This information you provide will be used to assist SCNN in arranging accommodations for twenty-five (25) students and their teacher from the University of Electronics, Science, and Technology of China (UESTC) who will visit CNU from July 12 to July 26 for a Summer School Program. They will spend the weekend of July 18 through July 20 with local host families coordinated through Sister Cities of Newport News, Inc. Students will be picked up the afternoon of Friday, July 18 and will return to campus after dinner on Sunday, July 20.   If you are interested in hosting a student (or two), please complete and return this form by June 15 to info@sistercities-nn.com  or fax to 757.926.1349.  Your questions may be addressed to SCNN Executive Director Kate Helwig at: 757.926.1348 / c: 757.508-7163.  Thank you for considering this hosting opportunity!

Name:								Work Phone #: (	)			
Home Phone #: (	)					Email Address:					
Home Address:													
City/Zip:													

The delegate would □ have their own room OR  □ share a room in our home.
Would you be willing to house more than one student?       □ YES    □ NO
Degree of certainty that you can host?           □ 100%	□ 90%	□ 80%	□ 70%	□ 60%	□ 50%	□ 40%
□ Not able to host at this time but, ask that you retain my information for future host opportunities.

Name(s) of all other Individual(s) living in the home and relationship:
							Relationship:				Age:		
							Relationship:				Age:		
							Relationship:				Age:		
							Relationship:				Age:		

List the types of pets you have in the home:
Pet Name/Type:					Pet Name/Type:					
Our family interests are…											

I (we) would like to host because…										

I understand that as a host I am participating in a not-for-profit cultural exchange program and will receive no compensation, but may submit receipts for actual expenses incurred in hosting to SCNN, Inc. for a tax deductible donation receipt.  

Signature 							Date