Homestay Application

This form is for the sole use of the California School of English and will not be shared with any other persons or agencies.

* Required Fields

Family Name *

Address *

City *

Zip Code *

Name of Adult *

Gender *

Occupation *

Phone: Home

Mobile

Work

E-mail Address

Name of Adult

Gender

Occupation

Phone: Home

Mobile

Work

E-mail Address

Additional People in Home:

Name

Gender

Age

Relationship

Name

Gender

Age

Relationship

Name

Gender

Age

Relationship

Name

Gender

Age

Relationship

Is English the main language spoken at home? *

Other language(s) spoken in home:

We own the following pets:

Hobbies and interests of family members: (Helps us match students) *

Host Family Preferences

We can host the following number of students: *

We cannot accept student(s) during these months or dates:

We prefer students:

We prefer:

We prefer students from: (You can select more than one)

Asia

Europe

South America

No Preference

How did you hear about us:

We would like to host a foreign student for the following reasons:

Applicant Agreement: *

I certify that the above information is true and agree to inform California School of English of any changes.

Electronic Signature of Applicant *

Date *

Month

Day

Year

title

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