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APPLICATION FORM FOR STUDENTS PLEASE RETURN APPLICATION TO : International House of RI -
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| Date: | |
| Family Name | Personal Name: |
| Age | Sex: Male Female |
| Nationality | Home Address |
| Email:
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Are you married? |
| Spouseís Name | Number of children and their
names and ages:
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| Is your family coming with you? | Address in U.S. if known: |
| Telephone # in US (if known) | Expected Date of Arrival: |
| Field of Study/Department at Brown | Languages you speak: |
| Expected date of graduation
or departure:
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Religion (Optional) |
| Do you have any dietary restrictions
or allergies?
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Do pets (animals) bother
you? Are you allergic to certain animals? If yes, which ones?
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| Special Interests/Hobbies? | |
| In order for us to make the
best placement for you with a host family, please tell us a little about
yourself, your family, and your expectations of this program:
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