4001 Fifth Ave. Pittsburgh, PA 15213-3545 Phone: 412-683-0342 e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Home
Calendar

Friendship Partner Application

Please complete all fields in this form. It will help us to find an American Friendship Partner for you.

First Name:

Last Name:

Gender:

Age:

Religion:

Home country:

Email:

Phone Number:

Address Line 1:

Apartment Number:

Zip Code:

Marital Status:

Married
Single

If Married, is your spouse also in Pittsburgh?

Yes
No

Spouse's Name:

Do you have children?

Yes
No

If Yes, are they in Pittsburgh?

Yes
No

1. Child's Name, Age and Gender:

2. Child's Name, Age and Gender:

3. Child's Name, Age, and Gender:

What date did you arrive in Pittsburgh:

How long will you stay in Pittsburgh?

Why are you visiting Pittsburgh?

Student/Visiting Scholar
Employment
Here With My Spouse

University /Employer:

Major/ Occupation:

Do you have a car here?

Would you like to be matched with a:

Are you able to meet 1x month with your American Friend?

Yes
No

Anything else you would like to tell us about yourself or your family?

Thank you for taking the time to fill out this form. Someone from the PRISM Staff will contact you soon.

Joomla Professional Work

Programs & Activities

Home
Program of Activities
Our Location
New! Summer English Class
PRISM Open House
Bible Studies
Cooking Class
Activities Registration
Calendar
Friendship Partners
Garage Giveaway
Holiday Hosting
Trips and Tours
PRISM Staff
ContactPRISM
Class Cancellation Policy
PRISM Office information
Test Form

Latest Events

Wed, Sep 8th, @10:00am - 11:30AM
Women's Bible Study

Sun, Sep 12th, @6:00pm - 08:00PM
Open House

Wed, Sep 15th, @10:00am - 11:30AM
Women's Bible Study

Fri, Sep 17th, @10:00am - 12:00PM
Cooking Class

PRISM

Pittsburgh Region International Student Ministries
4001 5th Ave.
Pittsburgh, PA 15213
USA

(c) 2008 Pittsburgh Region International Student Ministries.
Design by NodeThirtyThree and Free CSS Templates.
Courtesy Open Web Design