Single Person Third Reference Form

This form is to be completed by someone other than the Host Family's Area Representative in fulfillment of U.S. Department of State Federal Code 62.25(j)(9): Ensure that a potential single adult host parent without a child in the home undergoes a secondary level review by an organizational representative other than the individual who recruited and selected the applicant.  Such secondary review should include demonstrated evidence of the individuals friends or family who can provide an additional support network for the exchange student and evidence of the individual's ties to his/her community.