Be A Host
Host Teen Application
2017 Host Teen Application
State / Province / Region
ZIP / Postal Code
Teen's Date of Birth
Teen’s Cell Phone
Please enclose a recent school photo
Mother's Cell Phone
Father's Cell Phone
Age of sister(s):
Age of brother(s):
Please list pets
Please provide two non-family individuals (teacher, coach, minister, other adult) that would be willing to give us a reference.
Reference #1 Name
Reference #1 Relationship
Reference #1 Email
Reference #1 Phone
Reference #2 Name
Reference #2 Relationship
Reference #2 Email
Reference #2 Phone
This information will be used to match you with a Northern Irish teen; honest answers will improve your chances of a suitable match.
Please write a short biography to introduce yourself.
What kind of music do you like?
What instrument(s) do you play?
Do you sing?
Do you dance?
What sports do you play?
What sports do you like?
Least favorite foods
Are you a vegetarian?
Are you allergic to any foods?
If yes, what?
What do you do in your free time?
List your school/church/volunteer activities; include any leadership positions
Do you like to watch tv?
Do you enjoy parties?
Do you like to talk with one or two friends, rather than a group?
Do you like being with groups of people?
Do you like meeting new people?
List three adjectives that describe yourself:
What are your plans for the future?
Why are you interested in participating in the Ulster Project?
What do you hope to gain from the experience?
What do you believe you can offer as a Host Teen?
© 2017 Ulster Project Cincinnati