High School USA
Host Family Application

Welcome to the Host Family Application form!
Please fill out the following fields carefully and we'll notify you as soon as possible of your pending application. All information is confidential.
Note: Your application will not be submitted until you have previewed it and then clicked on the "Submit Request" button.
**Please be aware that we are required to run a background check on all families hosting one of our students.**


 
Mother's Information
Last Name First Name
Occupation eMail Address
Cell Phone Work Phone
Birth Year  
 
Father's Information
Last Name First Name
Occupation eMail Address
Cell Phone Work Phone
Birth Year  
 
Family Address
Street & Apt.
City State
Zip Home Phone Number
Children and other people living in your home
Name Birth Year Sex Living At Home?
Airport Code (3 letter) City, State
When would you like the student to arrive?
How did you hear about Quest?
Which best describes your annual household income:
Family Details
Please list any special eating habits of your family (80 words max.)
What is the frequency you have family dinners together (days per week)?
Where will your student have a quiet place to study?
Religious affiliation of
Mother Father Children
Your family's religious involvement
Your family attends services
Your family understands that the exchange student has the right to decide if he/she will attend services with your family (unless it is required by the private school).
Have you ever hosted an exchange student?
If yes, what agency?
School Transportation
How far from the school do you live (in miles)?
How much time do you expect the student to spend commuting to school (in minutes)?
What transportation method will be used?
Family Information
Tell us about your family's hobbies, interests and weekend activities (120 words max)
Describe a typical weekday in your home (120 words max)
Describe how you would hope to see your exchange student integrate with your family (120 words max)
Please give a brief description of each family member, including his or her interests, responsibilities etc. (120 words max)
Home Environment
Do any members of the family smoke?
If YES, are they smoking inside the house?
Describe your home and neighborhood (120 words max)
Household pets or Animals - Specify number, breed, indoor/outdoor (120 words max)
What chores would your student be expected to do? (120 words max)
How much time do you expect to spend with the student on weekends?
What accomodations will you have for your student?
If sharing, provide Name and Age of roommate
Name Age
Community
Community Name Nearest Large City
Distance by car Population (approx)
 miles
Select which best describes your home:
Describe your community, City/Town i.e. scenic, geographic location (120 words max)
Please describe the weather in your area from Aug - Jun; will your student need weather appropriate clothing? (120 words max)
What activities, cultural or recreational events are in or around your area? (120 words max)
Personal References.
(non-family members)

Personal Reference 1
Last Name First Name
Phone eMail Address
Address
City State Zip

Personal Reference 2
Last Name First Name
Phone eMail Address
Address
City State Zip

Personal Reference 3
Last Name First Name
Phone eMail Address
Address
City State Zip
Please write a greeting to your exchange student (120 words max)