Northern Illinois University

International Student & Faculty Office

Communiversity Ambassador Program - Community Memeber Application

Contact Information
Family (Last) Name
First Name
Gender Male
Female
   
Email Address
Phone Number
Local Address
 
Family/Home Life
Spouse Name (if applicable)
Name/Age/Gender of each Child (if applicable)
Number/Types of Pets
Allergies or Dietary restrictions
Languages you and your family speak
Countries you've lived in or visited and when
 
Interests/Activities (Check all that apply)
Music
Reading
Instruments you play Piano Violin Guitar Drum
Other
Sports you watch or play
Soccer Cricket Jogging Am. Football Volleyball
Water Sports Golf Table Tennis Skiing Basketball
Swimming Basketball Tennis
Other
Outdoor Activities
Biking Boating/Canoeing Hiking
Fishing/Hunting Camping
Other
Movies Comedy Classics Adventure Romance
Sci-Fi Thriller
Other
Other Interests Singing Theatre Painting/Drawing Cooking Cards
Chess Politics
Other
Hosting Preferences
Number of students you would like to host
Gender Male Female No Preference
Marital Status Married Not Married No Preference
Children Student has children Student does not have children
No Preference
Countries of Interest