Christmas Homestay Request

Christmas Homestay Request

International Students
STUDENTS (only), submit this form to Mrs. Julian by October 15 to apply for a host during Christmas break. Hosts are assigned in the order applications are received.

If we cannot provide a host, we will notify you by December 1, and we will refund your money. We will not accept homestay requests after October 15.

Please note that the dormitory will close at 12:00 p.m. on December 19, 2026, and reopen on January 2, 2027, at 12:00 p.m.

Dormitory and School Calendar
Student Name

Legal SurnameLegal Given Name
Preferred Name
Nickname
School Email
example@mysclutheran.org
Expectations

The homestay program is designed to enhance your cultural learning within an American home setting. Hosts are carefully selected by SCLA. They provide students with more than a place to stay. Hosts are eager to get to know you and learn more about your culture while they share American home life and Christmas traditions with you.

As with any learning opportunity, the amount of effort you put in affects the value you get out. So, while extra rest and communicating with your own family are important and expected during the break, you will also strive to know your host and participate in their activities. If you submit payment, you agree to...
1. Remain with your host during the full hosting period while the dorm is closed.
2. Show your host gratitude and respect.
3. Spend some time each day without your phone for meals and activities.
4. Make time to talk and interact with your host each day.
5. Ask your host for help if you do not understand the rules or if your needs are not being met.
If you do not agree with these points, please talk to your parents about making other arrangements over the break, and let another student have this opportunity.
I Understand and Agree to the Expectations.
Explain Why You Would Like a Homestay
Reason for Homestay Request

Other
Have your parents agreed to this?
Father's Name

First NameLast Name
Father's Email
example@example.com
Mother's Name

First NameLast Name
Mother's Email
example@example.com
Agent's Email
If you do not have an agent, type "None."

Personal Information

This information will be shared with your host. This section is to be completed by the STUDENT ONLY.
Your SCLA Email Address
example@mysclutheran.org
Your Legal Name
Preferred Name
What name would you like your host family to call you?
Birthday

MonthDayYear
2 digit month, 2 digit day, 4 digit yearMonth/Day/Year - select from calendar.
Home Country
Home City
Grade
What grade are you in?
Activities at School
What activities, teams, or clubs are you involved in at SCLA?
Other Interests
Tell about something you like to do outside of school.
Future Goals
What are some of your goals for the future?
Favorite Foods
Favorite American Foods
Foods You Dislike
Homestay Wishlist
What kinds of activities would you like to do with your host during the break?

Payment

Please make a payment to reserve your homestay.

Christmas Homestay Fee

$825.00 Quantity

Total

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

Christmas Homestay Request

Personal Needs

Personal Information

Payment