Registration (Guiding Family) Personal Details Email* Prefix* Select prefix Mr. Ms. Mrs. Dr. First Name* Last Name* Username* Primary Mobile Number* Password* Confirm password* Spouse Name Secondary/Spouse Mobile Number Street Address* City* State* Please select state Alabama Alaska Alberta American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of British Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Minor Outlying Islands Mississippi Missouri Montana Nebraska Nevada New Brunswick Newfoundland and Labrador New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Northwest Territories Nova Scotia Ohio Ontario Oklahoma Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas U.S. Virgin Islands Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Yukon Nearby major city* Total members in your household ? How many total students can you host at a time?* Select number 1 2 3 4 5 6 7 8 9 10+ Do you have a preference for Female or Male Students?* Female Male No Preference In what ways you can help students? select at least one* I can house a student(s) and take care of their early needs. I can pickup and drop off from the airport or local area. I can assist with food or groceries. I can do all of the above. No, I decline to participate. "Other" Would you like to join our team and become Regional Director (3 yrs) for this noble cause? Select Your Choice Yes No I acknowledge the terms and guidelines of JAINA for the guiding families and will abide to them.* I acknowledge the terms and guidelines of JAINA for the guiding families and will abide to them. Guidelines can be found here ( https://jsgc.jaina.org/guidelines ) Comments or concerns?
