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Family Name:
Given Name:
Gender : Male Female
Age: Date of Birth
Home Country
City or Province:

Note: If you do not yet know your Chapel Hill address and/or telephone number of if your Chapel Hill address or telephone number changes, be sure to notify us.

Chapel Hill Address (Present):

Phone (Present):

Lab or Office Phone:
Email: Fax #:

Classification:
Undergraduate Exchange Graduate
Visiting scholar Spouse

Major/Field of research:
Degree Sought:
How long do you expect to be at UNC?

Occupation in Home Country:

Besides English, list languages you speak:
Languages you read and write:

Have you visited the U.S. previously? Yes No             
If yes, how long and in what capacity?

Married? Yes No  
Spouse coming? Yes No
Date spouse coming (approximate):
Spouse's Name:
Children coming? Yes No
Names and ages of children, if they are coming.

Religion (optional)
Dietary Restrictions


Special Interests
Below, please check the areas that are of most interest to you. Give us as much information and as clear a picture of yourself as you can.

Art Film Dance Music Literature Travel Sports Theatre
Government & Politics Business & Industry Education & Schools


OISSS Programs in which You are Interested in Participating
Indicate your interest by checking the box next to the name of the programs in which you are interested in participating.

Speakers' Bureau
The Speakers' Bureau serves the local community by providing international speakers to schools, civic and religious organizations. The students and scholars at UNC-Chapel Hill provide a valuable educational resource for information and international understanding. You may be invited to volunteer to speak about your home country and culture, show slides, or demonstrate native dress, music, foods, and/or crafts. Checking this box does not obligate you. It lets us know that we may contact you if we have a request for a program from a group that is interested in learning about your country. Transportation will be provided.

Would you be interested in giving talks about your country to schools and other organizations in the community?
Yes No
Would your spouse be interested?
Yes No

Do you have a special talent (such as playing a musical instrument or performing national dance, singing, crafts demonstrations) which you would be willing to share with school, civic or university groups?



International Women's English Conversation Group
This program provides the spouses of international students and scholars the opportunity to meet other women from around the world as well as American members of the Chapel Hill community. They learn about local activities for internationals and their children, and have English conversation lessons in a relaxed atmosphere. Babysitting is provided. This group meets on Thursdays from 10:00 a.m. to 12:00 p.m. at a private home. If you check this box, we will send you more detailed information when you arrive.