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Host Family Application for Students



Date of Application:
Name:
Address:
Telephone:
Date of Birth:

Age:


Country of origin:


Primary language you speak:


Other languages you speak:


Do you have any brothers or sisters? If so, what are their ages?


Other countries you have visited:


Religious preference:

Length of time you have been in the United States:


Length of time you have been at Canisius College:


College Major:

What are your special interests or hobbies?


If you have any questions, please contact our office at (716) 888-2784. Thank You!