Account

Does any member of the household suffer any chronic illness? Please specify who and nature of illness.

Does anyone in the household speak another language? If so,who, and which languages?

Does your family have any pets? If so,how many and what kind?

Has your family ever hosted and exchange student?
YesNo

Do you have any especial concerns about hosting? If so, what are they?

What chores will your student be expected to do?

What does your family hope to get out of hosting a foreign exhange student?

ALL MEMBERS OF THE HOUSEHOLD

Is your family willing to host a boy, girl or either?
BoyGirlEither

What type of accommodations can you offer the international student? A private bedroom is not neccesary, but he/she must have his/her own bed. If a student is going to share room, with whom will it be?

FAMILY LIFESTYLE

What does your family do for fun in the evening or on weekends?

What type of person would best fit into your family?

I give my permission for any photos taken to be used for promotional material for future Elsa and Friends programs
YesNo

How did you hear about Elsa and Friends?

Signature of Host Father

Signature of Host Mother

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