Faculty and Staff Host Form
On behalf of the Butler Center, we thank you for supporting the Colorado College Friends of CC Host Program. In the current national climate, we want to help ensure that none of our community members feel further traumatized or minoritized in a relationship that we are helping to foster. Therefore, with the revamping of our hosting program, we are implementing a system in order to best match hosts with our students. Please complete this form with the most pertinent information  to ensure that The Butler Center best matches hosts with students.
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Email *
Today's Date
MM
/
DD
/
YYYY
First and Last Name *
Name You Like to Be Called
Pronoun(s) *
(Ex. She/Her/Hers, He/Him/His, They/Them/Theirs, Ze/Zir/Zirs, other)
Town of Residence *
Department/Position *
Availability *
Required
Indicate specific dates you are available: *
Are you willing to host students over night? *
If you are willing to host overnight, how many students would you like to host?
How many nights are you willing to host students?
Before meeting my student, they should know: *
Preferred Method of Contact *
How many adults, children and/or pets live in your home, including yourself? *
0
1
2
3
4
5 or more
Adults
Children
Pets
What type of pets do you have? *
Required
What hobbies/interests do you have that you would like your student to know? *
Required
Did you attend a host orientation? *
Are there any questions and/or concerns you have? *
Use this section to add anything that was missed in this form, and would support making the best match possible. If you do not have anything to add, please put N/A. *
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