AMITY Host Family Application
During the 2017-2018 school year Madison Elementary will play host to cultural interns from Spanish speaking countries.

Term 1: August- January
Term 2: January - Early June

Looking for families to host Interns that will be working at Madison Elementary.
Interns are young adults from Spanish speaking countries that spend their year teaching alongside immersion teachers.

Host Family Expectations would be to:
-Provide a private room for the AMITY Intern
-Maintain a clean and healthy living environment
-Provide room and board for AMITY Interns (Including food & household necessities). Host families are volunteers and will not be paid
-Transportation to and from school (Teachers-staff can help with this if there is an issue)
-Include AMITY in family traditions, practices and holidays
-Include AMITY interns in family outings

Security
All AMITY Interns are required to have a clean background check prior to participating in this program.

By filling out this form, you are showing interest to receive more information/be contacted regarding hosting an AMITY Intern.

Family Name/s
Apellido/s de familia
Your answer
Address
Dirección
Your answer
E-mail
Your answer
Home Phone
Telefono
Your answer
Please list family members, ages, and genders below.
Miembros de familia, edad y sexo abajo.
Your answer
Parent Occupation/s
Ocupaciones de los padres
Your answer
What hobbies or interests do you and your family participate in? (check all that apply)
¿Cuales pasatiempos hace usted con la familia? (Elige todos que se aplican)
Do you have any pets?
¿Tiene usted mascota?
If yes, please specify pets.
Your answer
Please choose your preferred term.
Elige las fechas preferidas
Is your home smoke free?
Do you have a separate/private room for the AMITY intern?
Do you have separate bathroom facilities?
Can you provide transportation to and from school?
If the AMITY intern cannot attend weekends or time away, are you willing to leave them home alone?
Do you have a gender preference?
Do you belong to any clubs or groups?
Your answer
If you are not interested in a full term, are you willing to host an AMITY intern in case of an emergency?
Additional comments/Information:
Your answer
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