New Host Family Application Form
Email address *
In which hosting opportunities are you interested? *
Required
Comments:
Your answer
Date of application *
MM
/
DD
/
YYYY
How did you hear about GlobalPittsburgh? *
Your answer
Your Name *
Your answer
Home Phone
Your answer
Cell Phone *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
Date of Birth *
Your answer
Marital Status: *
Do you have children?: *
If employed, your current employer: *
Your answer
Title: *
Your answer
Regular Work Schedule and Hours *
Your answer
Work address
Your answer
Phone:
Your answer
Education *
Your answer
What are your hobbies and interests? *
Your answer
What languages do you speak besides English?
Your answer
If you have traveled internationally, what countries have you visited/lived in?
Your answer
What type of cuisine do you generally prepare for dinner (American, Asian, Italian, Kosher, vegetarian, vegan, etc.)?
Your answer
Does your family have any food sensitivities or allergies? *
If yes, please explain so that we may inform your potential guests
Your answer
Is your home accessible by public transportation? *
Please explain your answer (e.g., closest bus or T stop)
Your answer
Would you prefer to host: *
What is the minimum age of a guest that you will be willing to host? *
Your answer
Are there any restrictions of which you would like us or your guest to be aware?
Your answer
Does your family have (a) cat(s)? *
If yes, how many, breed, etc.?
Your answer
Does your family have (a) dog(s)? *
If yes, how many, breed, etc.?
Your answer
Do you or any member of your family smoke? Please note, if you or any family member smokes inside the house we will not be able to place students with you. *
Would you host a student who smokes? *
Do you have wifi in your home? *
Will the student have a private bathroom? *
Your answer
Will laundry facilities be available to your guest? *
List any other facilities that will be available for your guest to use
Your answer
How many bedrooms are available for your guest(s)? *
How many guests can you host at the same time? *
Starting on January 1, 2020, our monthly rates for hosting homestays (overnight guests) are $550 with no meals; $700 with breakfast and dinner; $800 with breakfast, dinner and a packed from home lunch. Please refer to a host family guidebook for more information about the meals requirement. Please check all options that you would consider: *
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