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FLS International Homestay Application

Date of Homestay Application: Student Name:


Family Name First Name Middle Name

Home Address:
Street Address or P.O. Box

City

State/Department/Province

Postal Code

Country

Telephone

Fax

Student Email Address

Agency [if applicable]

Homestay Start Date: Circle One Homestay Option: Personal Preferences: Does not have pets Does not have children Single Room Twin Room

MALE

FEMALE

Does not smoke Does not allow alcoholic beverages Non-vegetarian

Has pets ( ) Dog ( ) Cat ( ) Birds Has children ( ) Small Family ( ) Large Family ( ) Infant(s) ( ) Young Children Smokes Allows alcoholic beverages Vegetarian

( ) Teenagers

List any allergies: _____________________________________________________________________ List dislikes [food / animal / other]: ______________________________________________________ Circle the qualities that best describe your personality / character: Active Organized Artistic Outgoing Athletic Positive Curious Quiet ] Family-Oriented Sensitive Shy Humorous Sociable Independent Studious

Religious [Preference:

Please write a letter of introduction in English to your prospective host family. Include information about your family life and daily routine in your home country, along with your educational and professional background, favorite indoor and outdoor activities, sports, movies, music, hobbies, and foods. If you have traveled or studied abroad before, please describe the circumstances and state your impressions. Indicate your personal and educational goals.
[Additional pages may be attached]

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