Thank you
for your interest in becoming a host family with Seattle Homestay. If you would
like to become a host family for international students, please complete the
online form below. Before you send this form after completion, please read our
Terms & Conditions carefully. You can also print this application form,
fill out and fax or mail it to us.
Fax Number: 253-835-4341
Address: Seattle Homestay
P.O. Box 25615
Federal Way, WA 98093-2615
Your First Name: _______________________ Your Last Name:
_______________________
Title: __Mr.
__Ms. __Mrs. __Miss. Date of Birth: _____ /______/________
Occupation: ________________ Company Name:
__________________
Home Address: _______________________________________
street
____________________
__________________
city zip code
Telephone Numbers
Home:
_____________________ Work: _______________________ Cell: ____________________
Best time to contact you:
Fax Number: ______________________ Email Address:
________________________________
Please list members of your family and other people living
at home.
Name: ___________________ Age ____ Relationship to you
____________ Occupation _________
Name: ___________________ Age ____ Relationship to you
____________ Occupation _________
Name: ___________________ Age ____ Relationship to you
____________ Occupation _________
Name: ___________________ Age ____ Relationship to you
____________ Occupation _________
Name: ___________________ Age ____ Relationship to you
____________ Occupation _________
Name: ___________________ Age ____ Relationship to you
____________ Occupation _________
Do you speak English as a mother language? ___ Yes ___ No
What language do your family members usually speak at home?
_____________
What are main activities or hobbies of your family? A.
________ B. _________ C. __________
Do your family have pets? ___ Yes ___ No
If Yes, What kind of pets? ______________ Where do the pets
live? ___ Inside ___ Outside
Have you or any other family member ever been arrested or
convicted for any criminal offense? ___
Yes ___ No
Are there any special health considerations in your family?
___ Yes ___ No
Homestay Information
How many bedrooms are available for Homestay? Shared Room ___ Private Room ___
Is the internet connection possible in the rooms? ___ Yes
___ No
Could you share your computer with the students for a short
time? ___ Yes ___ No
Do you have an operating smoke alarm installed in your
home? ___ Yes ___ No
How many international students can you accommodate? ___
Do you prefer male students or female students? ___ Male
___ Female ___ No Preference
Do you provide international students with Dinner? ___ Yes
___ No
Would you permit outside smoking? ___ Yes ___ No
Is your home located within walking distance to a bus stop?
___ Yes ___ No
Please write down the bus route numbers if possible. 1.
_____ 2. _____ 3. _____
What is the college name which is the nearest from your
home? _____________________
Would you be willing to provide airport pick up service for
the students? ___ Yes ___ No
Have you ever hosted international students before? ___ Yes
___ No
Are there any comments you would like to leave to the
future guests?
If you know any persons who are interested in becoming
hosts for international students, please recommend them to us.
Name: __________________________ Telephone ________________________
Email Address: ____________________________________
q
The hosts should speak English as a mother language.
q
The home should be safe and comfortable, and has warm and
hospitable environment.
q
The hosts should treat the students with respect and
tolerance.
q The students
should be able to arrive to their school by bus with no more than 40-50 minutes of
traveling time.
q The home
should be located within 10 minutes walking distance to a bus stop.
q The hosts
should provide a clean furnished bedroom and a bathroom facility for
international students.
q The hosts
should provide the students with a breakfast & dinner, but if hosts want to
provide only Bed & Breakfast (B&B) you should inform Seattle Homestay
of the fact at the time of application.
q The
families should be friendly and helpful so that the international students are
given plenty of opportunity to practice their English.
q The hosts
should provide each student with a key into the house.
q The host
families should be willing to include the students in family activities.
q The hosts
should provide appropriate parent supervision for the students.
q The rules
under Pricing & Policy should apply as payments and refunds
procedure. To enter Pricing & Policy you can just click on Homestay.
q The hosts
are strongly encouraged to provide airport pick up for the students as a mark
of welcoming them.
q Seattle
Homestay recommends that the hosts provide the written house rules to ensure a
mutual understanding.
q The hosts
should understand that Seattle Homestay is not liable for any damages or loss
caused by the hosts or the students.
By
singing below, I certify that the information provided above is accurate, and I
have read and understood the terms and conditions of Host Family.
Full
Name: ________________________________ Date: _____/_____/_______
_______________________________________
Signature
§ Please send us a recent family photo. This is not
mandatory.
§ Seattle Homestay will be contacting you by phone or email
shortly after receiving your
application.