Japan Host and/or Travel Interest Form 2020
Hosting is from May 14-18, 2020
Traveling is from June 15-25, 2020

Please complete this form by Feb. 21, 2020 to indicate your level of commitment moving forward. If you have any questions please contact:
South families please email Steve Perkins (sperkins@sd25.org)
Thomas families please email Nick Filipowski (nfilipowski@sd25.org).
Thank you!
What is your child's name? *
Your answer
Parent's Name(s) *
Last Name, First Name
Your answer
Parent Email *
Your answer
Parent Phone Number *
Your answer
What Middle School does your child attend? *
What grade is your student? *
Are you interested in traveling to Japan or hosting or both? *
*We only have 12 slots for D25 students traveling to Japan and 15 slots for D25 host families!
The remaining questions are for those interested in hosting. If you are not interested in hosting, you may skip to the bottom and submit
Please indicate how many students you are able to host:
(The students are always hosted in pairs, but on a small number of occasions a third student has had to stay with a host family)
Please indicate preferred gender of students to host
If hosting, please indicate if you would be willing to also host a teacher from Japan.
A small number of chaperones from Japan also visit with the students.
Please list the name, age, and gender of everyone who resides in your household.
Example: Bobby (12) Male, Jessie (8) Female, Pat (43) Male, Jordan (40) Female
Your answer
Do you have any pets? If so, please list below.
Your answer
Please provide your address
Your answer
Is there a specific student you would like to host? If so, please provide their name and the reason you would like to host them.
My child stayed with this family in Japan previously, this student's sibling stayed with us, etc.
Your answer
Is there any other information you would like to share with us?
Your answer
Never submit passwords through Google Forms.
This form was created inside of Arlington Heights School District 25. Report Abuse