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Student Application
At Arizona Homestay, we do our best to make sure we match you with the best host home. It is very important that you include all the information below so that we can find the right host for you. Please call us with any questions.We are happy to help. Application and Placement Fees : $395 College. $520 High School/ Middle School
College student pricing for 4 weeks - $775 with meals. $650 with no meals.
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* Required
First
*
Your answer
Middle
*
Your answer
Family Name
*
Your answer
Email address
*
Your answer
Gender
*
Male
Female
Age
*
Your answer
Will you be attending:
*
College / University Student
High School Student
Trade School or Language School
Required
Date of birth
*
MM
/
DD
/
YYYY
Have you been fully vaccinated for Covid-19? (This will not impact your application, this is for our information only)
*
Yes
No
When do you want to start homestay?
MM
/
DD
/
YYYY
When will you leave homestay?
MM
/
DD
/
YYYY
Current address
*
With City - Country - State/Province
Your answer
Nationality
Your answer
Language spoken
*
Your answer
Secondary language spoken
Your answer
Phone #
*
(please make sure you have a local number in the US
Your answer
Religion
*
Your answer
What college will you be attending?
*
Your answer
When does your class session start?
*
MM
/
DD
/
YYYY
What are you studying?
Your answer
How long will you need homestay?
*
1 - 2 months
3 - 4 months
5 -6 months
6-12 months
1 year or more
Other:
What is your student VISA # if you have it
Your answer
Passport #
Your answer
What is your flight number?
Your answer
Airline?
Your answer
Flight arrival time
Your answer
Date of Arrival?
*
MM
/
DD
/
YYYY
Will you have a car while in the US?
*
Yes
No
Why do you want homestay?
*
Your answer
Parent or Agent names
Your answer
Parents or Agent email
please include contact email address
Your answer
Parent or Agent phone
Your answer
Emergency Contact name and phone number
*
Your answer
English level
*
level 1
level 2
level 3
fluent
Interests and hobbies?
*
Your answer
Have you studied in the United States before?
*
Yes
No
Have you been in Homestay before?
*
Yes
No
Will you live in a home with small children?
*
Yes
No
Will you be needing meals during homestay?
*
Yes
No
Do you have a special diet/food requirements?
*
Your answer
Do you drink alcohol?
*
Yes
No
Do you Smoke?
*
Yes
No
Many Americans to have pets. Can you live in a home with Cats or Dogs?
*
Yes
No
Describe your personality?
*
(Quiet, outgoing, social, serious)
Your answer
What do you want your homestay family to know?
*
Your answer
What are the 2 most important things you want in homestay?
*
Your answer
Please list any dietary restrictions, allergies or medical problems you have.
*
Your answer
How did you hear about Arizona Homestay?
*
Internet Search
Friend / Family
School Website
Other:
How will you be paying for Homestay? Credit card, cash, bank transfer, etc.?
*
Your answer
Please read the Student Agreement below. By Signing this application below, you agree to the terms and guidelines of the Arizona Homestay Student Document included in this application.
I certify that the above information is correct to the best of my knowledge. If provided information is shown to be incorrect, the application will be null and void and above applicant will not be able to stay with an Arizona Homestay host. By signing the application electronically, I authorized Arizona Homestay to verify the above information.
Please type your name below as signature.
*
Your answer
Date
*
MM
/
DD
/
YYYY
Submit
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