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:
School Fax Number:
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?
How will the student get to and from school?*

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?