Up with People » Host Family Form

City you'd like to host in:*

Host family living is one of the most exciting and rewarding components of the Up with People program. The partnership between local families and Up with People cast members creates a true global community. Together you will learn from and create relationships with people from different cultures and communities across the globe. Up with People host families provide:

A safe and welcoming environment for UWP students
Knowledge about your local culture and community
A place to sleep
Breakfast and most dinners
Local transportation at the beginning and end of each day

Up with People host families receive:

A cultural immersion experience as customs and traditions are shared between your cast member and your family
Exposure to a global citizen philosophy and mindset
The opportunity to serve your community, working side by side with your cast member in volunteer projects
New connections that often develop into lifelong friendships
Two complimentary Up with People show tickets

Contact Information

Name*

First Last

Cell Phone

Other Phone

Email

Preferred Contact Method

Cell Phone
Other Phone
E-mail

Spouse/Roommate Name

First Last

Kids? If yes, please write first name and age

Accomodation

Number of Up with Cast Members to host?

Preferred genders to host?

Check all that apply.

Male
Female

Number of Beds?

Will they be sharing a bed?

Yes
No

Type of Bed(s)?

Single
Queen
Bunk Beds
Air Mattress
Pull-out Couch

Can you provide transportation? Note: Typically, an 8am drop off and 6pm pick up, with an occasional late evening depending on city specifics*

Yes
No

Comments

For Allergy Purposes

Do you have any pets? If so, what kind and how many?

Do you or anyone in your household smoke?

Yes
No

Can you host a smoker? Note: Up with People cast members will ONLY smoke outside

Yes
No

Do you or anyone in your household follow a special diet? If so, what kind?

Can you accommodate a special diet? If so, what kind?

No/Only Regular Diet
Vegetarian
Vegan
Gluten-Free
Lactose Intolerant

Comments

Host Family Volunteer Application

Up with People (UWP) strives to create and maintain a safe environment for all who participate in the UWP program. This information may be provided to an outside agency that UWP has retained to conduct background checks. In some cases, applicants may be asked to obtain their own background checks for review by UWP staff.

Personal Information*

Please list all house-hold members 18 years and older…

Full Name	Date of Birth	State Driver’s License / ID Number

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How long have you lived at this address?

How did you learn of the hosting opportunity with UWP?

Personal Reference*

Name	Relationship	Phone	Email

I understand that by submitting my information, I am opting in to receive communications from Up with People related to this visit.*

I understand

CONSENT: I certify that all of the information provided within this application is true to the best of my knowledge and that I have not withheld any information that would affect this application unfavorably. By signing this Application, I acknowledge that I have read this Application and fully understand its contents.

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CONSENT I certify that all of the information provided within this application is true to the best of my knowledge and that I have not withheld any information that would affect this application unfavorably. I understand that UWP will deny a volunteer position to anyone convicted of a crime of violence, sexual abuse or harassment, or any other crime of a sexual nature and may deny a volunteer position to anyone who has been charged with these crimes. I give UWP permission to verify the information on this application, including reviewing the public records that I have provided, or by searching law enforcement and other published records (including driving records and criminal background checks) in addition to contacting the reference I provided. I understand that this information will be used in part to determine my eligibility for a volunteer position. I understand that I will have an opportunity to review my criminal history. I hereby confirm, represent, and warrant that I have never been convicted of or charged with a violent crime, child abuse or neglect, child pornography, child abduction, kidnapping, rape, or other sexual offense, nor have I ever been ordered by a court to receive psychiatric or psychological treatment in connection therewith. By signing this Application, I acknowledge that I have read this Application and fully understand its contents.

Electronic Signature*

First Last

Date

Host Family Registration

Contact Information

Accomodation

For Allergy Purposes

Host Family Volunteer Application