Host Families Application - Our Lady of Good Counsel High School

GOOD COUNSEL HOST FAMILY APPLICATION

Please note that your inquiry will be shared with homestay management agencies for the next steps.

Namerequired

Phonerequired

Addressrequired

Emailrequired

Affiliation with Good Counsel (i.e. current family, alumni, etc.)required

Describe the Best Match for YourequiredIndicate all that apply.

Indicate all that apply.

Why are you interested in becoming a host family?required

You will be responsible for providing a room with privacy, three meals a day, transportation between school and home, and overall well being of the student:required

Family Interests and Routinesrequired

Language/s Spoken at Homerequired

List language/s spoken at home.

Family Dietary Restrictionsrequired

List family dietary restrictions if any. Please indicate if there are none.

Household Pets?required

List family pets. Please note if you have none.

Relevant Experiencesrequired

List relevant experiences related to hosting international students.

Please list three people who are not related to you as references:required

Please include name, phone number and email address

List all members of your household. Please include each person's age and gender.

Family Member 1 | Full Name

Gender

Age

Family Member 2 | Full Name

Gender

Age

Family Member 3 | Full Name

Gender

Age

Family Member 4 | Full Name

Gender

Age

Family Member 5 | Full Name

Gender

Age

Family Member 6 | Full Name

Gender

Age

Family Member 6 | Full Name

Gender

Age

Are you currently working with any homestay agencies? Please provide names below. If none, please note none.

By Checking the Button Below, You Agree to a Provide Your Social Security Number and Photo ID for Background Check

Yes, I agree to provide a background check.

In-person / in-house Interview Record (to be filled out by school official)

Global Programs

Global Programs

Global Programs