Community Friend
Application
FIRST NAME
LAST NAME
OCCUPATION:
HOME ADDRESS: (STREET)
PHONE: DAY/CELL
GENDER:
□ MALE □FEMALE
(CITY)
(ZIP CODE)
EVENING
BIRTHDATE: MONTH/DAY/YEAR
EMAIL:
FAMILY STATUS:
□ SINGLE □ MARRIED
DO YOU
SMOKE?
□ YES □ NO
□ CHILDREN
RELIGION: (OPTIONAL)
COMMUNITY AND PROFESSIONAL AFFILIATIONS:
SPOUSE’S NAME/OCCUPATION
NUMBER OF CHILDREN:
KIND OF PETS:
MAJOR: (if student)
LANGUAGES YOU SPEAK:
HOBBIES:
PLACES YOU HAVE TRAVELED:
 I WOULD LIKE TO BE MATCHED WITH A STUDENT WHO IS □ MALE □ FEMALE □ NO PREFERENCE
*NOTE: Single Community Friends will be matched with persons of the same gender.
 I AM WILLING TO BE MATCHED WITH TWO STUDENTS? □ YES □ NO □ NO PREFERENCE
 MATCHING IS USUALLY BASED ON SIMILAR HOBBIES AND INTERESTS. THE MAJORITY OF OUR STUDENTS ARE FROM ASIA OR AFRICA
AND FEWER ARE FROM LATIN AMERICA OR EUROPE. IF THERE IS A CERTAIN COUNTRY IN WHICH YOU HAVE A SPECIAL INTEREST,
INDICATE THAT HERE AND WE WILL ATTEMPT TO MATCH YOU WITH A STUDENT FROM THAT COUNTRY _____________________________
 HAVE YOU PARTICIPATED IN THE LINK BEFORE? □ YES □ NO
List one reference whom we may contact for more information about you.
Reference_______________________________________________________Relationship_____________________
Telephone ______________________________________ How long have you known this person?_______________
PLEASE READ CAREFULLY: Yes, I want to participate in The Link, UTA’s International Friendship Program. I
understand that I will receive more information on this program once my application has been reviewed. I understand
that this program is for the purpose of friendship and cultural exchange. I will respect the culture, religion, beliefs and
customs of my international friend. I will not use the program to proselytize or as a dating service. I am committing to
meet my friend once a month if possible. I will complete an evaluation at the end of the school year and notify the
coordinator of any program concerns or problems.
Today’s Date:_____________________
Signed:
PLEASE COMPLETE AND RETURN TO:
THE UNIVERSITY OF TEXAS AT ARLINGTON, OFFICE OF INTERNATIONAL EDUCATION
BOX 19028, SWIFT CENTER, 1022 UTA BLVD. ARLINGTON, TX 76019
FAX: 817-272-5005
For more information contact Josh Garcia
EMAIL: joshg@uta.edu PHONE: 817-272-2355
For Office Use Only
DATE RECEIVED:
STUDENT MATCH:
PHONE:
DATABASE ENTERED:
DATE MATCHED:
ORIENTATION: