Host Family Registration English Italiano Française City you'd like to host in:*Grand Island, NE (August 26-September 2)Tulsa, OK (September 2-9)Lafayette, LA (September 9-16)Ruston, LA (September 16-23)Shreveport, LA (September 23-30)Ottawa, ON, Canada (October 1-12)Potenza, Italy (October 14 - 21)Sarnano, Italy (October 21 - 28)Agrigento, Italy (October 28 - November 4)Palermo, Italy (November 4 - 11)Brindisi, Italy (November 11 - 18)Donaueschingen, Germany (November 18 - 25)Nyon, Switzerland (November 25 - December 1)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 ticketsContact InformationName* First Last Cell PhoneOther PhoneEmail Preferred Contact MethodCell PhoneOther PhoneE-mailSpouse/Roommate Name First Last Kids? If yes, please write first name and ageAccomodationNumber of Up with Cast Members to host?12345678910+Preferred genders to host?Check all that apply. Male Female Number of Beds?123456+Will they be sharing a bed?YesNoType 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*YesNoCommentsFor Allergy PurposesDo you have any pets? If so, what kind and how many?Do you or anyone in your household smoke?YesNoCan you host a smoker? Note: Up with People cast members will ONLY smoke outsideYesNoDo you or anyone in your household follow a special diet? If so, what kind?No/Regular DietVegetarianVeganGluten-FreeLactose IntolerantCan you accommodate a special diet? If so, what kind? No/Only Regular Diet Vegetarian Vegan Gluten-Free Lactose Intolerant CommentsHost Family Volunteer ApplicationUp 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 NameDate of BirthState Driver’s License / ID Number Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country How long have you lived at this address?How did you learn of the hosting opportunity with UWP?Personal Reference*NameRelationshipPhoneEmailBy clicking this box, I consent to receiving communication from Up with People, knowing that I may update my communication preferences or opt-out of communication at any time* 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. Read More 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 Date Format: MM slash DD slash YYYY
