Billet Host Family Questionnaire

Billet Host Family Questionnaire

Please take a moment to tell us about yourself and/or your family.
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
E-mail
Other family members in the home. (please include name, sex and age)
Do you have any pets? If so, what type?
What will the bedroom/bathroom arrangements be for the player(s)?
YesNoThere are smokers but they smoke only outside
High school studentPlayer attending collegePlayer workingNo preference
123
Yes but with no winter plug-inYes with a winter plug inNo room for an extra vehicle
Family interests/activities
Please list any previous experience as a host family
Please list any KL Gold Miner staff or current host families that you know
Why are you interested in billeting?
Please add any other information you think would be helpful in placing a player in your home.
Should be Empty: