Host Family: Student Application

Personal Information
Name (first, middle initial, last):  
Nickname:  
Native Country:  
Languages:  
Do you smoke?
   
   
 
Does cigarette smoke bother you?
   
   
 
Do you have Allergies?
   
   
 
If yes, please list.  

Contact Information
Colby Address: 
Colby email: 

Program Information
What are your interests? (These may include sports, music, games, art, travel, etc.)
 
What are your preferences? (List your like or dislike for children, animals, etc.)
 
We will do our best to match you with a host family according to your interests. Please use this space below to share any additional information. (Confidential)