International Friendship & Learning Host Family Application 2012 Name of Local Host Family Coordinator______
Please send application to
Family Last Name
Mother´s Name
Occupation
Employer
Work Number ( )
Father´s name
Occupation
Employer
Work Number ( )
Names of Children: Sex: Age: Lives at home: School attending/ Occupation:
Family´s Address:
City: State: Zip:
Home Phone Number: ( )
Cell Phone Numbers: ( )
Email Address: @
Current Marital Status:
married seperated
remarried divorced
single widowed
shared household
Will anyone else, not listed above, be staying at your home during the student´s stay. If so, please list full name and relationship to the family.
Do both parents work outside of the home? YES NO
Will someone be home with the student during the day? YES NO
If yes, who will be home?
If you had a choice, would you prefer a male or female student?
Will the student share a bedroom? If so, with whom?
Are there any other languages besides English spoken in the home?
If so, which language/languages?
If there are no children living in the home, do you know anyone around the student´s age that you could introduce him or her to?
Do you have any pets living in the home? If so, which animals?
Does anyone in your family smoke?
Inside the home?
What is your religious affiliation, if any?
Have you ever hosted a foreign exchange student before?
From which country? For how long?
Do you have any ideas of what you would like to do with your guest during their stay?
Please list two non-relative family references, their relationship to your family and their phone number. These references will be contacted.
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Please tell us more about your family´s interest and hobbies by marking an X next to any that apply, indicating the family member who practices it:
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reading
swimming
boating
fishing
camping
hunting
skateboarding
winter skiing
water skiing
rock climbing
hiking
jogging
cooking
going to parks
scrapbooking
arts and crafts
gardening
attending church services/mass
picnics
canoeing
kayaking
riding bicycles
animals
horseback riding
*computers
shopping
board games
visiting museums
painting/drawing
art
movies
barbeques
golf
tennis
basketball
baseball
soccer
football
hockey
volleyball
theater
video games
music
playing musical instruments
amusement parks
dancing
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* In order to get to know your Spanish student better, the organization requests avoiding long periods of surfing the internet. The students who participate in the program are only allowed a maximum of 15 minutes per day to communicate with their family by email (or any other means of communication).
Other Interests and Hobbies/Otros Intereses y Hobbies:
How would you describe your family members? (outgoing, quiet, active...)
According to Ley Orgánica 15/1999, on the Protection of Personal Data, we inform you that your personal data will be used in order to maintain the contractual relationship between the organization and the host family and the agreements derived from the contract. By signing this form, you grant your express consent to the processing of your family´s health and religious information with the purpose of valuing your request to host and student assignment.
For exercising your rights to access, correct, cancel and oppose your data, please contact International Friendship & Learning, at the address: Avda. José Luis Arrese, N·35, 8·C, Valladolid, Spain, 47014.
The most beneficial and successful stays for everyone involved are with families in which all members positively look forward to and equally participate in this experience. By signing below, each member of our family agrees to having a new “family member” from abroad this summer. We agree to treat them as another member of the family during their stay, integrating them into our daily lives as much as possible. We will try our best to make sure the student is not exposed to underage drinking and smoking or anything else that is against US laws and International Friendship & Learning´s rules and expectations. We will speak to our student in English, therefore helping him or her in their quest to improve their level.
Signatures of all Family Members that will participate
Signed (Month and Day) of 2012.
Thank you for your generous hospitality!
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