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Contact Information

For more information or assistance,
complete the appropriate fields and
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(fields marked with an astrisk (*) are required):

*Name:

*Address:

*City:

*State:   *Zip Code:

Phone:

*Email Address:

University Attending:

Field of Study:

Degree you are working on:

Anticipated Completion Date:


Marital Status:

Spouse's Name:   Is your spouse here?


Gender:   Birthdate:

Visa:

Religion:


Home Country:   Date Arrived in U.S.:


Address in Home Country:


Interests

English Conversation Practice
Social Activities
English Language/Grammar Lessons
Sightseeing Trips
Learning More About The Bible
Small Group International Dinners
Conferences And Retreats During School Breaks
Friendship Partner Program (being matched together with an American host family for friendship)


Practical Needs (check all that apply):

occasional transportation to stores
transportation to church
help with shopping
need of furniture/housing
need help finding specific things
help with banking
help with classes(looking for an American professional in your field of study to act as a mentor)


Is there any other way we can help or
is there any question we can answer for you?


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