Homestay Application for INTERLINK Language Centers

HOMESTAY APPLICATION

Please note the following important information:

A non-refundable $150 homestay placement fee and two recent photos are required along with the application form.
INTERLINK must receive this application 4-8 weeks before your arrival.
The homestay cost which includes room and board is approximately $600 each month, depending on location.
Upon arrival, you will be required to pay a $300 deposit. This deposit will be refunded if you leave the home with a two-week advance notice and if there are no outstanding charges, such as telephone bills.
If your plans change or you cannot come on the date for which you have registered, notify us immediately.

Please type all the information requested below. When you are finished, click on "Submit" below.

1. Indicate which center are you applying to:
2. Indicate when you want the homestay to begin: term year
3. Method of payment of application fees:
4. Family Name:
First Name:
Mailing Address:
City:
Country: State/Province:
Phone Number: Email:
Date of Birth: Country of Citizenship:
Native Language: Present/Future Occupation:
How long do you plan to stay with your host family?weeks

EDUCATIONAL BACKGROUND

5. Highest educational level completed:

Secondary University Post Graduate

6. Please rate your English conversational ability:

very good

good

fair

poor

FAMILY PREFERENCES

7. Do you wish to stay with a family that: (preferences cannot always be accommodated)

has small children?
yes nono preference

has a cat?
yes nono preference

has a dog?
yesnono preference

smokes?
yesnono preference

8. Please indicate all that apply to you:

Male Female
Drink alcoholic beverages Do not drink alcoholic beverages
Smoker Non-smoker

9. Do you have any allergies or medical problems or are there any foods you cannot eat?

Yes No

If yes, please explain:

10. Do you have any difficulties walking or other physical conditions that your homestay family should know about?
Yes No
If yes, please describe:

11. What are your hobbies and interests?

EMERGENCY CONTACT PERSON

12. Full Name:

Address:

Phone Number:

5. Highest educational level completed:
Secondary University Post Graduate
6. Please rate your English conversational ability:
very good
good
fair
poor

7. Do you wish to stay with a family that: (preferences cannot always be accommodated)
has small children? yes nono preference
has a cat? yes nono preference
has a dog? yesnono preference
smokes? yesnono preference
8. Please indicate all that apply to you:
Male Female Drink alcoholic beverages Do not drink alcoholic beverages Smoker Non-smoker
9. Do you have any allergies or medical problems or are there any foods you cannot eat?
Yes No
If yes, please explain:

10. Do you have any difficulties walking or other physical conditions that your homestay family should know about?
Yes No
If yes, please describe:

11. What are your hobbies and interests?