Student Host Family Program Application

Gender *
Will you need transportation? *
Any allergies/special dietary needs? *
Do you want to share your host family with other international student(s)? *
What kind of activities do you like? *
Western Wyoming Community College is an Equal Opportunity institution, and as such, does not discriminate on the basis of race, color, national origin, sex, age, religion, disability or veteran status in admission or access to, or treatment or employment in, its educational programs or activities. For inquiries concerning Title VI, Title IX, Section 504, ADA , or to access grievance procedures, contact Amy Galley, Western Wyoming Community College, 2500 College Drive, Rock Springs, WY 82901, phone: (307) 382-1645 or Office for Civil Rights, Denver Office, US Department of Education, Cesar E Chavez Memorial Building, Suite 310, 1244 Spear Avenue Blvd., Denver, CO 80204-3582, (303) 844-5695, Fax: (303) 844-4303 or TDD (303) 844-3417 or the Wyoming Labor Standards Department, 1510 East Pershing Blvd., Cheyenne, WY 82002 (307) 777-7261.
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