Online Application for Host Family


CONTACT INFORMATION

* Address   * City   * State   * Zip Code
     
* Family/Last Name   * First Name   Middle Name
   
* Email   * Day Time Tel   * Evening Time Tel
  - -   - -

HOUSEHOLD MEMBERS *

Name   Relationship   Sex DOB (MM/DD/YY) Occupation
   
   
   
   
   

GENERAL INFORMATION

Primary language spoken at home: 
Secondary language spoken at home:
List all pets:
Which pets are allowed indoors?
* Do you host students from other schools?
If yes, which school?
* Interests or activities engaged in as a family or with students:
Type of Home:
No. of bedrooms:
No. of bathrooms:
No. of bedrooms for hosting:
Other amenities (i.e., pool, gym, etc.):
Student's bathroom:
* Please list student's room amenities (i.e., telephone, television, computer, etc.):
Any additional information about your house:
Public transportation accessible from your house:
* Campus:
Estimated commuting time to campus, including walking and wait time by Google: (minutes: Numeric only)
 

HOSTING REQUIREMENTS & PREFERENCES

* Homestay Option: $ /month
Gender preference:
* May students prepare their own food? 
Smoking policy: 
* Requirements related to religious practice:
* Any additional requirements, preferences, rules, etc.:
 
*  Applicant's Statement
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