Host Family Application

This information is protected under the Privacy Act of 1995. Completion of this form, or any portion of it, is voluntary. Failure to complete the entire form will render the applicant ineligible to participate in the Abilene Home Away From Home program.

Name

Year of birth
For background check

Spouse Name

Spouse Year of birth
For background check

Employer/Occupation

Address

Email 1

Email 2

Phone

May we share your contact information with your assigned Airmen's families and base staff members?

Yes No

Ethnicity

African American Asian/Pacific Islander Inter-racial Hispanic Native American No answer Caucasian Other: ‎

Religious Affiliation

Agnostic/Atheist Baptist Buddhist Catholic Church of Christ Islamic/Muslim Jewish Methodist Mormon/LDS Non-denominational Protestant Uncommitted Unknown No Answer Other: ‎

Sports & Hobbies
Select all that apply

Aviation‎ Baseball‎ Basketball‎ Bicycle‎ Board games‎ Computer/Video games‎ Cooking/Baking‎ Fishing‎ Football‎ Golf‎ Horseback riding‎ Hunting‎ Motorcycle‎ Musical instruments‎ Racquetball‎ Swimming‎ Tennis‎ TV/Movies‎ Watching sports‎ Watersports‎ Other: ‎

Preferences: Please rate the strength of your preferences so we can appropriately match you to Airmen.

Very Important
Important
Neutral
Somewhat Important
Not Important

Ethnicity

Religious Affiliation

Sports

Do you have any of the following in your home?
Select all that apply

Cat(s)‎ Dog(s)‎ Other pet(s)‎ Children‎ Other adults (over 21) besides you and your spouse‎ Smokers‎

Please list any other people living in your home over the age of 21
If you need to list more than two additional adults, use the "other considerations" section at the bottom of this form.

Adult 3 Year of birth
For background check

Other Adult 2

Adult 4 Year of birth
For background check

What are the ages of your children?

Airmen gender preference:

How many Airmen are you willing to host? (min 2)
Please note that Airmen room together in groups of three, and may prefer to be assigned to the same family.

What is your preferred way to communicate?
Select all that apply

E-mail‎ Text‎ Voice‎

Do you have base access at Dyess?

Yes No

Is there anything else you'd like us to consider when matching you to Airmen?

Verification