|
|
|
IHPS Homestays Host(s) Application Form
|
| We are:
|
|
| First Name: |
|
Last Name: |
|
| First Name: |
|
Last Name: |
|
| Address |
|
Apt/Condo # |
|
| City |
|
State |
|
| Zip Code: |
|
Home Phone: |
|
| Work Phone: |
|
Cell Phone: |
|
| *Email (Valid email address is required):
|
| (Mr.) Host Occupation and name of Company:
|
| (Ms.) Host Occupation and name of Company:
|
Please list all children, OR other family members/ non-family members (borders, students) living in the home.
|
Name Male/Female Relationship Age
|
Are all family members/ others living in the home in good health?
|
If no, please explain:
|
| Housing Type: |
| Do you have a backyard pool?
|
Community Pool? |
|
Internet Service is Mandatory for our Participants at no additional charge:
Do you have internet service available for a Participant?
|
Is it wireless? |
|
| Does the room have Cable/Satellite TV?
|
Does it have a private bathroom?
|
| Do you have laundry available in the home for a Participant?
|
|
|
| Student Preferences:
|
How many Participants can you host in private rooms?
|
Would you be willing to provide Breakfast and Dinner for the Participant?
(Breakfast is student prepared and dinner is prepared by the host at least 4 nights of the week)
|
Are you a Vegetarian? |
|
| Do you have pets in the home?
|
If Yes, please describe: |
|
| Are the pets kept:
|
|
|
| Do you have parking available if a Participant has a car?
|
If yes, Please describe (street, garage, driveway):
|
| Is a parking permit required?
|
What is the distance in miles to the nearest bus/Metro stop from your home?
|
| Please list the names of any schools your home is near to (please refer to our list of school on our homepage): |
| School #1: |
|
Distance: |
|
| School #2: |
|
Distance: |
|
| School #3: |
|
Distance: |
|
| Please list any bus lines you may know about:
|
|
|
| Have you ever hosted a person in your home from another country?
|
If yes, please explain? |
|
| Have you ever traveled to another country?
|
If yes, please explain: |
|
| Please describe your hobbies and interests: |
|
| If you are chosen to Host an IHPS Participant, how will you integrate him/her into your/family life? |
|
| Why would you like to host a Participant in your home? |
|
|
|
| Please provide two character references (excluding family members): |
| Name: |
|
Name: |
|
| Phone: |
|
Phone: |
|
|
| Relationship: |
|
Relationship: |
|
| **Please be as accurate and explanatory as possible on your application. We will confirm receipt of your application by email and notify you once we have a Host need for your area. A housing coordinator will come to your home to interview you, see the room and answer any questions you have about our program. He or She will also take a digital photograph of the room and you or your family to include in your host profile. Please feel free to list your Homestay availability on our sister site www.worldhomestay.com |
| I have read, understand and accept the IHPS Hosting Agreement [pdf]. |
(Please print a copy for your records) |
| |
| Today's Date: |
|
Electronic Signature: |
|
Image verification * :
|
| *Please enter what you see in this box below. |
| |
| |
