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Homestay Application Form

To apply for your homestay, please complete the form below:
* Choose Event:
 Contact Information:
* First Name:   * Last Name:   
* Street:    * City:   
* State/Province:   *   ZIP Code:    *   Country: 
* Phone:       * E-mail:    
  Education:  Occupation:    
  Gender:
Age:    
  Language:
  To receive a host family profile, please enter your fax number:    

 Group Information:
* Number of travelers in your group including yourself  . Please list your traveler's name, age, gender and occupation (The more information you can give us, the better we can serve you):
First Name:      Last Name:   
Education:    Occupation:    
Gender:
Age:    
First Name:      Last Name:   
Education:    Occupation:    
Gender:
Age:    
First Name:      Last Name:   
Education:    Occupation:    
Gender:
Age:    
First Name:      Last Name:   
Education:    Occupation:    
Gender:
Age:    
First Name:      Last Name:   
Education:    Occupation:    
Gender:
Age:    


 Personal Preferences:
Do you prefer to stay with a family: ( Ages: )
Do you smoke:           Do you object to smoke:
Do you prefer a family: ( What kinds? )
Do you have any medical problems? ( What kinds? )
Do you have medical insurance?
Are there any foods that you cannot eat? ( Please list: )
Your hobbies & interests (and other comments):


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