Host Registration Form

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Your household including anyone who stays with you regularly
First & Surname Gender Date of Birth Occupation Nationality Smoker
Pets: Do you have*
- No pets
- Cats
- Dogs
- Other
Tell us about your family
How do you describe your family*
Tell us about your family's interests, hobbies and any pets*
How often do you have dinner together?
- Every day
- 3-4 times a week
- Weekends only
- Never
In addition to English, what languages are spoken in your home?
Our students are here to speak English but sometimes they welcome the opportunity to speak in their native language so it's good to know what other languages you can support with.
Have you hosted international students before?*
- Yes
- No
Tell us about any experience with children*
Tell us about any international experience*
Does your family hold religious beliefs and if so, what?*
Do you or anyone in your household have a criminal conviction?*
- Yes
- No
Please provide details

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Your home
Where do you live?*
Street Address City County / State / Region ZIP / Postal Code
What setting is your home?*
Describe your home - public rooms, bedrooms, spare room, en suite facilities etc.*
Describe your Wifi*
- Limited
- Unlimited
- Fast
- Average
- Slow
Do you have a piano that students could use?*
- Yes
- No
Tell us about nearby public transport

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Hosting - who and when?
Would you prefer a girl or a boy?*
- Girl
- Boy
- No preference
Do you have an age preference?*
Minimum age
Maximum age
Do you have a language preference?*
Can you cater for a special diet?
- Halal
- Vegetarian
- Lactose free
- Gluten free
- Nut free
- Other
Give details
Do you have a religious preference with regards to who you host?*
What level of involvement do you expect the student to have with your family?*
Are you available to pick up from school or would you prefer us to arrange taxis?*
How many students would you like to host together?*

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Is there anything else you would like us to know?
How did you hear about Academic Families?*
Please upload a photo of your family, of your home and of your pets (if applicable).
Drop files here or

Max. file size: 20 MB, Max. files: 4.
Please let us know if you would like to hear from us in the future*
I would like to be informed about Academic Families services and agree to the use of my email address for such information in accordance with data protection regulations
- Yes
- No
Comments
This field is for validation purposes and should be left unchanged.

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Host registration form

First & Surname	Gender	Date of Birth	Occupation	Nationality	Smoker