Host Family Application

Host Family Application

Please complete this application to begin the process of becoming an MPA Host Family.
Today's Date:

MonthDayYear
Date
Host Parent #1 Name:

First NameLast Name
Host Parent #1 Employment:
Host Parent #1 College or University Attended:
Host Parent #1 Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Host Parent #1 Email:
example@example.com
Host Parent #2 Name:

First NameLast Name
Host Parent #2 Employment:
Host Parent #2 College or University Attended:
Host Parent #2 Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Host Parent #2 Email:
example@example.com
Home Address:

Street Address

Street Address Line2

CityState

Zip Code
Other Residents in Home:
Please answer the following questions to assist us in matching an international student with your family.
Please list activities in which your family engages (recreational, social, cultural, artistic/musical, religious, etc.):
Please list any pets and/or animals your family owns (those living within your home or on your property):
Does anyone smoke inside or outside the home?
Does anyone in the family have dietary restrictions?
If so, please describe:
Are you comfortable hosting a student with dietary needs or food allergies?
How do you feel about hosting a student who holds different religious beliefs, practices different religious customs, or does not practice a religion?
What languages are spoken in your home?
How would you describe the personality of your family?
Please describe the daily routines, habits, expectations, and responsibilities of your family and its members:
Are you able to provide the student their own bedroom?
Are you able to provide the student their own quiet study area?
Please add any additional comments about your family that will help us know you better and make a good match for both your family and the student:
How did you learn about becoming an MPA host family?
MPA Employee's Name:
MPA Family's Name:
Please Describe:
Has your family hosted a student in the past?
Please describe the experience:
Are there any considerations your family would like us to honor in regards to the placement of an international student (e.g., our family is vegan and we do not purchase animal products, etc.)?
If so, please explain:
Should be Empty: