HOST APPLICATION - La Société Française de Bienfaisance Mutuelle

HOST APPLICATION
La Société Française de Bienfaisance Mutuelle

Thank you for your interest in the International Volunteer Program and for your willingness to open up your home to an international volunteer. Finding hosts is a very challenging task, and we sincerely appreciate your generosity. If you have a recent photograph of your family would you please share it so that we may send it on to your guest? We would also be happy to forward on any other information or materials you would like to share with your guest. The information below is used to help select the best guest for your home, so please think carefully and be as specific as possible. If you need more room, please feel free to use a separate sheet of paper. Please complete the following application, typing or printing, and return it to our offices, or to the volunteer agency. Thank you very much.

Host Name: ________________________________________________________________

Phone No.: _________________________________________________________________

Agency Affiliation: ___________________________________________________________

Address (with zip code please): ________________________________________________

__________________________________________________________________________

How many volunteer guests can you accommodate? _______ Preferred Gender? ______

How long will you be hosting? (number of weeks): ________________________________

Are you a smoker and/or do you mind a smoking guest?___________________________

Is smoking permitted outdoors? _______________________________________________

Tell us about yourself and your family. Are you single? Do you have children? (ages, interests). Do you have pets - what kind(s)? What kind of work do you do? What are your special interests, tastes, preferred activities, etc.? Why are you interested in taking in a volunteer?

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Tell us about your home and the area in which you live. What is special about the neighborhood, the town? How is the public transportation? (For example, if you were coming to stay with a host in another country, what would you most like to know about them?)

______________________________________________________________________________

What kind of sleeping and eating accommodations do you have available? _________________

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Do you have a special diet? (i.e. vegetarian, vegan, religious etc.) ________________________

______________________________________________________________________________

Please share your expectations for a volunteer guest in your home. Do you have any special concerns or limitations?

______________________________________________________________________________

Thank you for completing the questionnaire. Please fax/mail to:

The International Volunteer Program
210 Post Street, Suite 502
San Francisco, CA 94108
Ph: (415) 477-3667
Fax: (415) 477-3669

- HOST CONTRACT -

I hereby submit this Application as a request to participate as a host for the International Volunteer Program (IVP). Should this application be approved, I agree to provide housing and 3 meals per day (unless other arrangements are made by the participating agency) to the IVP volunteers assigned to my home during the amount of time specified in the application above. I understand that I will receive no remuneration for this from the International Volunteer Program or La Société Française de Bienfaisance Mutuelle.

I hereby release and forever discharge the International Volunteer Program, all participating volunteers, La Société Française de Bienfaisance Mutuelle, The French Hospital Foundation, their trustees, directors, employees, officers and staff, including their respective properties, from any and all damages arising from or related to any injury, illness, or death and/or property damage sustained by me, my family or any other person or entity, during my participation in the International Volunteer Program.

I hereby agree to defend and hold harmless the International Volunteer Program, all participating volunteers, La Société Française de Bienfaisance Mutuelle, The French Hospital Foundation, their trustees, directors, employees, officers and staff, including their properties, from any and all damages, including but not limited to costs, fees, attorneys’ fees, and/or judgments, relating to or in any way connected to my participation in the International Volunteer Program, including but not limited to all my acts and omissions during said Program. I hereby declare that I read carefully this contract and understand its content.

Signature: ________________________________________________ Date: ______________

Thank you again for your interest and support.