PITTSBURGH COUNCIL OF INTERNATIONAL VISITORS
APPLICATION FOR AIRPORT MEETING
AND ARRIVAL HOMESTAY
PLEASE PRINT ALL INFORMATION
DATE:_________________________________ TITLE: Ms.____ Mrs. ____ Mr. ____ Dr. ____
NAME:______________________________________________________________ MALE____ FEMALE _____
(family name) (first name) (middle name)
ADDRESS IN HOME COUNTRY: ____________________________________________________________________
____________________________________________________________________
FAX:_______________________ TELEPHONE: _______________________ E-MAIL: _______________________
NATIVE LANGUAGE: __________________________ OTHER LANGUAGES: ______________________________
AGE: _____________ HOBBIES/INTERESTS: ___________________________________________________
AIRPORT MEETING: Do you wish to be met by a PCIV volunteer when you arrive at Pittsburgh Airport?
(service available only between 8:00 AM and 10:00 PM) YES_______ NO_______
DATE OF ARRIVAL:_________________ TIME OF ARRIVAL: _______________ FLIGHT NO.: _______________
NAME OF AIRLINE:______________________ ARRIVING FROM (this flight's city of origin)___________________
THREE-DAY HOMESTAY: Do you wish to spend three days with a host family when you arrive in Pittsburgh?
(You cannot stay with your hosts longer than 3 days) YES______ NO________
INFORMATION TO ASSIST HOST FAMILIES AND DRIVERS:
PLEASE ENCLOSE A SHORT LETTER ABOUT YOURSELF TO THE HOST FAMILY.
FAMILY MEMBERS WHO WILL ACCOMPANY YOU TO PITTSBURGH (names, ages, and relationship to you):
________________________________________________________________________________________________
Do you smoke? YES____ NO____ ALLERGIES: Cats_____ Dogs_____ Smoke_____ Other:__________________
DIETARY RESTRICTIONS--CHECK THE FOODS THAT YOU DO NOT EAT:
Pork_____ Beef_____ Cheese_____ Milk_____ Eggs_____ Fish_____ Any Meat_____
Sugar_____ Salt_____ Other:________________________________________________________
Any additional information that you would like to share?___________________________________________________
ADMINISTRATIVE FEE: Pre-registration homestay fee should be discussed with the Director of Programs. Please make a check payable to Pittsburgh Council for International Visitors.
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Your request cannot be processed unless the following information is included: _______Completed form _______Enclosed check written to PCIV _______"Dear Host Family" letter _______Arrival flight information |
PLEASE RETURN COMPLETED FORM BY AIRMAIL TO: Pittsburgh Council for International Visitors Phone: 412-392-4513 |