Homestay Application

Host Status *
---FamilyCoupleSingle

Last Name *

First Name *

Gender *
---MaleFemale

Date of Birth *

Occupation *

Work schedule *

Last Name

First Name

Gender
---MaleFemale

Date of Birth

Occupation

Work schedule

Street Address *

City *

State *

Postal/zip code *

Applicant's Cell Phone *

Applicant's Email *

Secondary Cell Phone *

Secondary Email *

Additional phone number (if there is one)

Last Name

First Name

Gender
---MaleFemale

Date of Birth

Lives at home?
---YesNo

Last Name

First Name

Gender
---MaleFemale

Date of Birth

Lives at home?
---YesNo

Last Name

First Name

Gender
---MaleFemale

Date of Birth

Lives at home?
---YesNo

Last Name

First Name

Gender
---MaleFemale

Relationship to host

Date of Birth

Occupation

Last Name

First Name

Gender
---MaleFemale

Relationship to host

Date of Birth

Occupation

Type of pet

Name of pet

Pet is kept
---InsideOutsideBoth

Type of pet

Name of pet

Pet is kept
---InsideOutsideBoth

Housing Type *
---HouseApartmentTownhouseOther

How many private bedroom and bathroom available for student *

The income data collected will be used solely for the purposes of ensuring that the basic needs of the international student can be met *
---less than $25,00025,000 - 35,00025,000 - 35,00045,000 - 55,00055,000 - 65,00065,000 or more

Have you ever hosted a international student? If yes please tell us when and the organization. *

Organization:

If yes, and if you know which school please list

In the space below, please tell us about your family. How would you describe the personality of your family? Do you have any special interests that you pursue together (sports, arts, travel, etc.)
Please fill out at least 1 field *

Please list any additional comments about your family that would help us to know you better and to make a better match between you and a BHI student. Please list the type of food you like to cook, special rules or diet you might have in the house that might be different from other families. ( family dinnertime, vegetarian/ vegan, bathroom rules etc)
Please fill out at least 1 field *

Summarize why your family would like to host an international student.
Please fill out at least 1 field *

Student Preference (If any)
---MaleFemale

Were you referred by another family? Please provide full name of the person who referred you.

Media/ Photo release: Is it okay if BHI needs to use any media (photo, etc.) taken in your home (usually with student) for advertising reasons on social media?

Name *

Relationship with host *

Phone *

Email *

Name *

Relationship with host *

Phone *

Email *