FIUTS Visiting Program Participant Information Form

Complete this form to share important information about yourself with FIUTS program staff. **This form is not an application; it is only for students who have been accepted to a FIUTS Visiting Program. If you have not been accepted into a program, please do not fill out this form.**

By what name do you prefer to be called?
Please write your name (first and last) as you wish it to appear on the name tag we will provide for you during the program.
What is your date of birth? *
What is your date of birth?
Please put your month of birth in the first field, followed by the day and year.
Gender *
Please note that smoking indoors is not permitted anywhere in Seattle.
For example; do you need to smoke frequently during the day, or are you able to go some time without smoking? As it can be somewhat challenging to find host families willing to accommodate smokers, it is important for us to understand whether you will need to smoke during your homestay.
(For example, allergic to pollen, shellfish, peanuts, cats, dust)
Please select each of the items that you are able to eat below. *
For example, opportunities for regular prayer, or help finding services to attend if possible.

Thank you for provided detailed information. The more we know about you, the better we can shape your program experience!