If you prefer PDF form, please download. Homestay Application PDF Download
* Required Field
Host Status *
Last Name *
First Name *
Date of Birth *
Work schedule *
Date of Birth
Street Address *
Postal/zip code *
Applicant's Cell Phone *
Applicant's Email *
Secondary Cell Phone *
Secondary Email *
Additional phone number (if there is one)
Lives at home?
Relationship to host
Type of pet
Name of pet
Pet is kept
Housing Type *
How many private bedroom and bathroom available for student *
Language spoken at home *
Anyone in your family smoke?
Smoking allowed outside?
Wireless internet available
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. *
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)
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?
Please list two references that may be contacted with regard to your suitability as a host family. References from work, school, or local community are preferred over close personal friends.
Relationship with host *
I hereby verify under penalty of perjury that the statements made herein are true and correct to the best of my knowledge. I furthermore authorize criminal background checks to be conducted if needed for each family member over the age of 18 in my household according to the requirements of my state of residence. I acknowledge that this application in no way guarantees the placement of a student in my home.
I Agree *
Name of host *
File Size: up to 2MB, File Format: jpg, png only.
21171 S. Western Ave. Suite 2703
Torrance, CA 90501
Operation hours: 10:00 - 18:00 M-F