GoldMiners Billet Host Family Questionaire
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Phone Number
-
Area Code
Phone Number
Phone Number
-
Area Code
Phone Number
E-mail
Other family members in the home. Please include name, sex & age
Do you have any pets?, If so, what type?
What will the bedroom/bathroom arrangements be for the player(s)?
Does anyone in the house smoke?
yes
no
There are smokers, but they smoke outside only.
Do you have a preference?
High school student
Player attending college
Player working
No preference
How many players are you able to accommodate?
1
2
3
Do you have room for a player's vehicle to be parked at the house?
Yes, but with no winter plug-in.
Yes, with a winter plug-in.
No room for an extra vehicle.
Family interests/activities
Please list any previous experience as a host family.
Please list any KL GoldMiners staff or current host families that you know.
What interested you in becoming a host family?
Please add any other information you think would be helpful in placing a player in your home.
Submit
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