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Centerville City Schools
Curriculum Department

Host Family Interest Form

The purpose of the Host Family Program for Recently Arrived Families is to increase engagement between local families and families who have recently arrived in Centerville from other countries. It provides informal opportunities for immigrant families to connect with volunteer host families in the Centerville community, agreeing to get together several times over the course of the year. Families and hosts build relationships that best fit their needs, meeting at mutually convenient times.

The program gives recently arrived families the opportunity to explore the Centerville community with their hosts, engage in meaningful dialogue, practice their English, and generally enjoy a connection to the community that they might not otherwise experience.

Please note that this is not a homestay program and financial support from host families is prohibited. The intent is for Centerville students to engage with host families along with their parent or guardian. The host family opportunity is open to all families regardless of whether or not they have students enrolled in Centerville Schools.

For more information, please contact our district English Language Learner Coach, Megan LeMaster, at (937) 433-8841.

Date of Applicationrequired (mm/dd/yyyy)

Namerequired

Preferred Phonerequired

Email Addressrequired

Address 1required

Address 2

Cityrequired

Occupationrequired

Are you employed with Centerville City Schools?*

Yes No

Please provide us with more information that will help us match you with a family.

Multilingual Skillsrequired

Please indicate any foreign language(s) in which you are fluent and would be willing to provide assistance to families who speak the same language.

Do you have children?*

Yes No

List age(s) or grade(s) of your children

Do your children attend Centerville City Schools?

Yes No

Do you prefer to be matched with a family that has students attending a particular Centerville School?*

Yes No preference

If so, list the buildings:

Do you prefer to be matched with a family that has students of a particular grade level?*

Yes No preference

If so, list the grade levels:

Special training, hobbies or interests

Please list any special areas of interest or skills you would like to share.

Is there anything else we should know?

Please send a confirmation email to the address below:

Please provide an email address where we can send a link to your current form.

Email Address :

Centerville City SchoolsCurriculum Department

Host Family Interest Form

Centerville City Schools
Curriculum Department