Host Family Application

 

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

 

General Information

 

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: ____________________________________

 

 

 

Terms and Conditions

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.