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Xplore USA Host Family Application
Welcome to Xplore USA! We are looking forward to welcoming you and your family to our international community at Xplore. Please fill in the details with as much information as possible. Students adjust and acclimate best when having a clear picture of their host family and the home they will be living in.
Email address *
I am applying to be a Host Family for the following program: *
Parent/Guardian 1: First Name
Parent/Guardian 1: Last Name
Parent/Guardian 1: Primary Contact Number
Parent/Guardian 1: Preferred Email Address
Parent/Guardian 1: Date of Birth
Day - Month - Year
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DD
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Parent/Guardian 1: Profession
Parent/Guardian 1: Employer
Parent/Guardian 1:Work Phone Number
Parent/Guardian 1: Preferred Email
Parent/Guardian 1: Please describe your work schedule including days and hours worked.
Parent/Guardian 1: Please list your interests, activities, sports and community involvement.
Parent/Guardian 2: First Name
Parent/Guardian 2: Last Name
Parent/Guardian 2: Primary Contact Number
Parent/Guardian 2: Preferred Email
Parent/Guardian 2: Date of Birth
Day - Month - Year
MM
/
DD
/
YYYY
Parent/Guardian 2: Profession
Parent/Guardian 2: Employer
Parent/Guardian 2: Work Phone Number
Parent/Guardian 2: Please describe your work schedule including days and hours worked.
Parent/Guardian 2: Please list your interests, activities, sports and community involvement.
Home Address *
Please include street, city & state
Zip Code *
Home Phone Number *
Best Skype Username Contact *
If your mailing address is different from your physical address, please add it here.
Our Family
Please list the Name, D.O.B & Interests of each family member.
Name of the first family member
Date of Birth of first family member
MM
/
DD
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YYYY
Please describe the first family members personality, hobbies and interests
Name of the second family member
Date of Birth of second family member
MM
/
DD
/
YYYY
Please describe the second family members personality, hobbies and interests
Name of the third family member
Date of Birth of third family member
MM
/
DD
/
YYYY
Please describe the third family members personality, hobbies and interests
Name of the fourth family member
Date of Birth of fourth family member
MM
/
DD
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YYYY
Please describe the fourth family members personality, hobbies and interests
Please list each additional member living in the home.
This is defined as anyone that sleeps two or more nights in the the home each week. Please include name age and relationship. Everyone over 18 must complete a background check.
What type of activities does your family enjoy doing together? *
Please describe your home and property. *
Please include number of bedrooms, bathrooms, yard, etc.
Please briefly describe your neighborhood and community area. *
Please also tell us what is interesting about it. For example, does it have events, festivals, theaters, sports and sights to see?
Does your family have pets? *
If the answer is yes to pets please give details below.
What language/languages is primarily spoken in the home? *
Please detail if anyone in your household speaks any other languages. *
What is your family's religious affiliation ? *
We ask our families to invite the students to their church services and activities but do not require them to attend. Are you comfortable with the student not attending? *
Does any one in your family smoke? *
If yes, please detail who it is and if it in inside or outside.
Does any host family member follow dietary restrictions? If so, name the person(s) & describe the restrictions *
Would you feel comfortable hosting a student who follows a particular diet? *
If yes, please detail below. For example vegetarian, gluten free, kosher etc.
Please share your family guidelines and expectations and what you would expect from your international student or guest? *
Will the Student be sharing a room? *
If yes, please specify. Please note students may only share a room with a child of the same gender and similar age.
What kind of experience do you envision for a student living in your home and becoming part of your family? *
Have you ever hosted an international student before? *
If yes, please specify program(s), country(ies) and year(s) and what the experience was like for you.
Have any family members ever visited a foreign country? If yes, please indicate which family member(s) and which country(ies).
Please tell us why you feel your family would be a good environment for an international guest? *
My Family can host: *
Required
Are you interested in hosting more than one student? *
Exchange students of the same gender and of two different nationalities can be placed with one host family. Host families enjoy this option because students offer extra support, friendship, and entertainment to each other, and families can experience two cultures. We fully understand that space in host family's homes is limited and this is often not an option!
Please list 3 Personal References, with at least 1 local to Asheville. *
Please list each reference's Name, Relation, and Phone Number.
Home Visit *
Home Visits are required for all new Xplore USA Host Families. An Xplore USA staff will visit your home (it usually lasts about an hour) and answer any questions in person. Please list days and times you are generally most available below.
How Did You Hear About Xplore USA? *
Have friends interested in hosting? We'd love to reach out to them!
Please list their names, best contact phone number, and town of residence. Thanks for referring!
Host Family Agreement *
Required
Certification:
By submitting this application, I certify I am a host parent in the host family submitting this application, and to the best of my knowledge, the contents of this application are true and accurate and that all members of the family support this application.
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