Student Application

Student Profile

Welcome! Please tell us about you so we can match you with the best host family for you!
First things first - Are you a Parent, Authorized Agent, or School Official completing this profile on behalf of the student?*

YesNo
What is your relationship to the student?*

Native ParentAuthorized AgentSchool OfficialOther
Student Name*

First NameLast Name
Preferred Name
American name or other name you would prefer us to use
Student Email*
Student Phone Number
Student Country of Origin*
City of US Education Provider*
School Location City
State of US Education Provider*
School Location State
➜ Click here to view the SRS Homestay Terms and Conditions
I have read and agree to the Terms and Conditions.*

Agree

Step 1
Your Student Profile 🌎
Help us match you with the right host family for you.
Student Gender*
Student Date of Birth*

MonthDayYear
Date
Passport Number
Passport Country of Issue*
What is your Nationality?*
Are you in high school or younger?*
Intended Start Date for Placement*

MonthDayYear
Date
Expected Length of Placement*
Name of Educational Provider*
Educational Provider Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Estimated First Day of School

MonthDayYear
Date
Estimated Last Day of School

MonthDayYear
Last Day of School or Graduation
What grade level will you be when you start your homestay?*
What age will you be when you start your homestay?*
Please provide a screenshot or file copy of your school schedule.

Providing your school schedule for the week will help us to place you with the most suitable host. If you are unable to provide this information for us now, please provide it to us as soon as it is available.
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Step 3
About You/Lifestyle 🏄
This information helps us find a family that will be a good match for your preferences and day-to-day life.
What is your level of conversational English?*
What language is spoken at home?*
Do you drink alcohol?*
Are you willing to live with other who drink alcohol?*
Do you smoke?*
Are you willing to live with others who smoke?*
Please list some of your hobbies and/or interests*
How would you describe your personality (choose all that apply)*

ShyOutgoingFriendlyQuietPatientKindActiveOther
Spirituality/Religion*
Please choose which choice best describes the type of relationship you hope to have with your host
What is your main reason for wanting to live with an American host family?*
Briefly introduce yourself to your host family*
This portion should be written for an international student to read. This will be shown to students looking for homestay in your area.

Step 4
Contacts 👥
Let us know who we can contact on your behalf
Native Parent or Authorized Agent
Parent Full Name: *
First, Middle and Last Name
Relationship to Student:*
Example: Mother
Parent Phone Number*
Parent Email Address*
Email address is used to send out Terms & Conditions prior to student arrival.
Agent Contact Details
Company Name*
Agent Full Name: *
First, Middle and Last Name
Agent Email Address*
Email address is used to send out Terms & Conditions prior to student arrival.
Are you studying abroad with a group? *
Group Name*
Initial Communication Email*
We will send all initiation communication to this email only.
Invoice Email*
We will end a copy of all invoices relating to ongoing billing

Service
Let us know what additional services you may need.
Insurance*
Insurance is required, please tell us if you would like to purchase insurance form SRS or if you will be purchasing your own.
Do you know your flight arrival details?*
If you know your flight arrival details , please let us know now. If you don't know yet, don't worry - you can update us later.
Do you need Airport Pick Up*
Flight Arrival Date

MonthDayYear
Date
Arrival Airport
Name of Airline
Flight Number
Flight Arrival Time

Hour Minutes

AM/PM Option
Anticipated Arrival Time at the Host Home

Hour Minutes

AM/PM Option

You're almost done!
Photos 📸
Hosts love to see a few photos of the student who will be living with them. Only two photos are required, but we encourage you to provide as additional photos.
Personal Photo(s)*

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Family Photo(s)*

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Other

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Other

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Please check the consent box below to complete your profile.
I give StudentRoomStay permission to share my profile and photos with host families in my area.*

Agree
Should be Empty:

Student Profile