Host Family Application

Thank you for your interest in becoming a host family with our program. Your support in providing a safe and welcoming home for international students is invaluable. Please complete the following application form to help us match students with suitable host families.

Photo Upload Requirements

Please note that to complete this application, you are required to provide photos of the following areas:

• House Exterior
• Common Living Areas
• Each Room with the Bathroom Available for Students

While it is recommended to include a photo of household members, it is not mandatory. Additionally, you have the option to upload additional pictures to showcase any special amenities, recreational areas, or features of your home that you would like to share with potential students. This could include photos of the backyard, study spaces, or any other areas you believe would enhance the student’s living experience.

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Contact Information

Name *

First

Last

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Email *

Phone *

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How did you hear about our Host Family Program? *— Select One —BingGoogleInstagramFacebookYahooYelpFormer hosted studentOther

Please specify. *

Household Information

Please provide the following details for all household members living in the host family’s house. In the Relationship column, indicate the relationship of each member to the primary contact person/host family.

How many household members? *— Select One —12345+

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1. Full Name *

2. Full Name *

3. Full Name *

4. Full Name *

1. Sex *— Select One —MaleFemale

2. Sex *— Select One —MaleFemale

3. Sex *— Select One —MaleFemale

4. Sex *— Select One —MaleFemale

1. Age *

2. Age *

3. Age *

4. Age *

1. Relationship *

2. Relationship *

3. Relationship *

4. Relationship *

All other members. *

If you have five or more household members, please list them, stating the name, sex, age, and relationship of each member.

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Are there any pets in the household? *

• Yes
• No

If yes, please specify. *

Languages Spoken in Your Household

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Primary Language Spoken *— Select One —EnglishSpanishArabicChineseFrenchJapaneseKoreanPortugueseTagalogVietnameseOther

Secondary Language Spoken— Select One —EnglishSpanishArabicChineseFrenchJapaneseKoreanPortugueseTagalogVietnameseOther

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Housing Details

Address *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

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Housing Type *— Select One —ApartmentDuplexCondominiumSingle-family homeTriplexQuadplexOther

If Other, specify. *

No of Bedrooms *

No of Bathrooms *

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House Exterior *

Click or drag files to this area to upload. You can upload up to 3 files.

Please provide pictures of the house. If you reside in an apartment or condo, kindly include pictures of the building and the entrance lobby, if applicable.

Common Living Area *

Click or drag files to this area to upload. You can upload up to 3 files.

Household Members

Click or drag files to this area to upload. You can upload up to 3 files.

Additional (Optional)

Click or drag files to this area to upload. You can upload up to 3 files.

If there are any additional photos you would like to share with students, please feel free to upload them here.

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Meal Provision *— Select One —Breakfast OnlyDinner OnlyBreakfast and DinnerNone (Student must cook their own meals.))

How many bedrooms are available for students? *— Select One —123

You may upload up to two pictures for each bedroom and bathroom.

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1. Bedroom *

Click or drag files to this area to upload. You can upload up to 2 files.

1. Bathroom *

Click or drag files to this area to upload. You can upload up to 2 files.

1. Bathroom Accessibility *— Select One —PrivateShared with MenShared with WomenShared with Men and Women

1. Monthly Rent *

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2. Bedroom *

Click or drag files to this area to upload. You can upload up to 2 files.

2. Bathroom *

Click or drag files to this area to upload. You can upload up to 2 files.

2. Bathroom Accessibility *— Select One —PrivateShared with MenShared with WomenShared with Men and Women

2. Monthly Rent *

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3. Bedroom *

Click or drag files to this area to upload. You can upload up to 2 files.

3. Bathroom *

Click or drag files to this area to upload. You can upload up to 2 files.

3. Bathroom Accessibility *— Select One —PrivateShared with MenShared with WomenShared with Men and Women

3. Monthly Rent *

Host Family Requirements *

Visual Text

Please provide any limitations, preferences, or specific house rules/expectations that the student should be aware of during their stay with your family. If you have no specific requirements or rules, kindly state “None” in the text box.

Acknowledgement *

• By submitting this application, I confirm that all the information provided is true and accurate to the best of my knowledge. I understand that completion of this form does not guarantee my selection as a host family. Furthermore, I acknowledge and agree that the information provided in this application, including accompanying photos, may be shared with prospective students who have applied for accommodation. I consent to a home visit as part of the selection process. These acknowledgements are made to ensure the integrity of the application process, facilitate the best match between host families and students, and prioritize the privacy and security of all parties involved.

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