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HTLC/LCM Adopt-A-Student Program

Please fill out the form, and press the submit button.

Contact Information
Name

Home Address

Email

Phone Number

Best Way to Contact

Best Time to Get Together

Preferences for Adopted Student
Male
Female
Either

Do you have children?

Yes
No
If yes, How Many?
If yes, Please List their names / ages

Do you have pets?

Yes
No
If Yes, Please Specify

Other Information
Occupation(s):

Other Places you have Lived:

Favorite Food:

Hobbies:

In my (our) Free Time, I (we) Like to :

If I (we) could go anywhere on vacation, I (we) would go:
My (our) favorite thing to do with my family is :

One sentence on why you would like to adopt a student:

I/We would like to keep the student(s) we were matched with last year.
The student(s) name(s): :