Host Family Application

HOUSEHOLD MEMBERS & EMPLOYMENT INFO

If you have more than 4 household members, please be sure to inform our staff when you are contacted for follow-up. You must included yourself here.
Person 1 Name *
Person 1 Age *
Person 1 Gender *
Person 1 Occupation or School Name *
Person 1 Employer *
Person 1 Position *
Person 1 Years in Job
Person 2 Name
Person 2 Gender
Person 2 Age
Person 2 Occupation or School Name
Person 2 Employer
Person 2 Position
Person 2 Years in Job
Person 3 Name
Person 3 Age
Person 3 Gender
Person 3 Occupation or School Name
Person 3 Employer
Person 3 Position
Person 3 Years in Job
Person 4 Name
Person 4 Age
Person 4 Gender
Person 4 Occupation or School Name
Person 4 Employer
Person 4 Position
Person 4 Years in Job

References

Three references are required for all applicants. (Please make sure and let each reference know that Twinn Palms will be contacting them.)
Reference 1 Name *
Reference 1 Relationship to You *
Reference 1 Phone Number *
Please enter a valid phone number.
Reference 1 Town *
Reference 2 Name *
Reference 2 Relationship to You *
Reference 2 Phone Number *
Please enter a valid phone number.
Reference 2 Town *
Reference 3 Name *
Reference 3 Relationship to You *
Reference 3 Phone Number *
Please enter a valid phone number.
Reference 3 Town *

Family Profile
Please write a paragraph or two about your family.
Tell us about your pet(s) if you have any.
Describe your education and/or your job.
Please share any info you would like about your social and religious affiliations.
Describe your typical family meal(s).
Describe your house.
Tell us about your usual family activities, from weekends and/or holidays.

ATTACHMENTS

If these are not attached, we cannot process your application

1) Pictures – Please attach a picture of the front of your house, living room, student bedroom, student bathroom, family pets, a typical meal, and a picture of all your family members. (7 total pictures)

2) Driver License – Please attach a copy of each person’s License who is over the age of 18, up to 3 people.

3) Proof of Auto Insurance – Please attach proof of insurance for each auto in the home, up to 3 people.
House Front *

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Living room *

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Student Bedroom *

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Student Bathroom *

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Family Picture *

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Additional pic(bedroom, pet, yard, etc)

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Typical Meal

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Kitchen Picture

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License of Driver 1 *

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Proof of Auto Insurance Driver 1 *

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License of Driver 2

(if applicable)
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Proof of Auto Insurance Driver 2

(if applicable)
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License of Driver 3

(if applicable)
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Proof of Auto Insurance Driver 3

(if applicable)
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The following PDF forms MUST be downloaded completed, signed, and attached below for your application to be complete. https://www.irs.gov/pub/irs-pdf/fw9.pdf https://twinnpalms.com/wp-content/uploads/2020/11/Twinn-Palms-Host-Family-Agreement_101719vF.pdf
Files: A completed W9 form and Host Family Agreement (see instructions p. 1) *

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Twinn Palms, Inc.