Host Family Application

Date of Birth

Relationship to Family

Do they live in your home full or part-time?

Which school would the student attend?
School Phone Number:
Format: (000) 000-0000.
School Fax Number:
Format: (000) 000-0000.
School Address:

Street Address

Street Address Line 2

CityState

Zip Code
What is the high school's approximate population?
How far is the high school from your home?
School busWalking or bicyclingRide with host parentRide with host siblingOther
Approximate school start date:
Approximate school end date:
Please provide a description of the high school (activities offered to students, campus description, student body, etc.):
Please list some activities that are available to teenagers in your community:*

Describe any concerns you may have about hosting an international student?*
How do your children feel about welcoming an international exchange student into their home? (If applicable)
Please describe a typical weekday in your household and give a brief description of your family's lifestyle.*
Why do you want to host an exchange student? What do you think your family will gain from a cultural exchange, and how will it benefit the exchange student?*
Please list some activities that would help you share your culture with an international student.*
Please describe your expectations regarding the responsibilities and behavior of the student while he/she is in your home. (i.e., completion of homework, household chores, curfew on school nights and weekends, household rules, computer/internet usage, etc.)*

Rows	Name	Gender	Date of Birth	Age	Do they live in your home full or part-time?