Host Application
* Indicates required fields
* Family Name  
* Applicant's Given Name (s)  
Spouse's Name (if any)  
* Home Address(Street)  
* City  
* State:
* Zip/Postal Code  
* Home Phone  
Work Phone  
E-mail Address  
Applicants Occupation/Title  
Spouse's Occupation/Title  
Family Children's Names
Children's Names Ages Sex
Live at Home?
Do you have pets? If yes, what kind?
Does anyone in your family smoke?
Please list your interests and hobbies
Do you have the resources and space in your home for an exchange student?
Name of nearest public high school
Preference for Exchange Student:
Nationality Preference
How did you hear about us?