Home Stay Application

Homestay Application Form

Please fill out the form below and press submit to send your application to FOA.

Family Name *

Host Father’s First Name *

Host Father's Date of birth *

Host Father’s position: *

Host Mother’s First Name *

Host Mother's Date of birth *

Host Mother’s position: *

Home Address *

City *

State/Province *

Zip Code *

Home Phone Number *

Work Phone Number

Moble Phone Number

Email Address *

Host Experience *

No

Yes/Where Yes/Where

List of People Living at Home (children/friends/relatives/other students)

Please click on the + taps to add names

Names

+-

Relationship

+-

Date Of Birth

+-

Occupation

+-

Current Living Situation?

+-

How many bedrooms do you have available?

	1 room		2 rooms		3 rooms		4 rooms
Please select how many bedrooms and beds you have in each room.

Pets (please indicate the number of animals) *

List how many pets you have each of (example: I have 2 indoor dogs, I have 1 indoor cat)

+-

Your Family…(Which best describes your family) *

Eat dinner together at least 3 nights a week.

Do spend much time together because everyone has busy schedules.

Eat dinner together at least 5nights a week.

Eat dinner at different times due to different schedules in the family.

Are active people-enjoy indoor or / or outdoor activity on regular basis

Easy going/ spend time relaxing in the evenings,

Other Other

Two Names of References We Can Contact * 🛈

+-

Phone Number: * 🛈

+-

What do you want to gain from this Home-Stay program? *

Notes: (Optional)

Please submit a photo of your family:

indoor dog	outdoor dog	indoor cat	outdoor cat
birds	fish	reptiles	Other Other