Host Family Application

* - required fields

Information About You
Please list your interests and hobbies:
* Do you have any physical or medical requirements?	Yes  No
If yes, please describe:
* Do you have any allergies?	Yes  No
If yes, please describe:
* Do you smoke?	Yes  No
Please describe your personality:
Which languages do you speak?
How many years have you studied English?
What is your level of English?	Beginner  Intermediate   Advanced
Do you have an international license to drive a car?	Yes  No
If yes, will you have access to a car?	Yes  No
Do you prefer a family with:	Small Children  Teens  Adults only  Any
Do you require a special diet?	Yes  No
If yes, please describe:
Do you prefer to live in the:	City  Suburbs  Country  Any

Additional comments or questions: