RIC Host Application

Rochester International Council

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Application for Volunteer Friendship Host

First Name Last Name
Nationality	Country of Residence
Date of Birth(mo/day/yr) Sex F M
Married NO YES Will your spouse accompany you? NO YES
Ages of children accompanying you:
DEAF?: NO YES Do you use sign NO YES language?

Information About Yourself: (Hobbies, interests, etc.)

Dietary Restrictions: (e.g. vegetarian, allergies)

How long do you expect to stay in Rochester?		Month/Year of Arrival
Name of School Degree Expected(BS,MS,PhD)
Department/Program

Current Address: Please provide contact information at which you can be reached from now until your arrival in Rochester.

Current Phone Number

Rochester Address (if known):

Rochester Phone Number

Rochester International Council
Morey Hall, Room 229, University of Rochester Rochester, NY 14627 USA
phone (585) 275-8779 fax (585) 756-8086 e-mail: jw@rifc.org
Office Hours: 10:30 am to 4:30 pm Eastern Time, Monday-Friday,
closed Thursday

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