Homestay Student Application Form.docx

Homestay Student Application Form LAST NAME FIRST NAME DATE OF BIRTH (dd/mm/yyyy) Gender (Male/Female) STREET ADDRESS CITY PHONE NUMBER EMAIL ADDRESS Twitter/Facebook (optional) NATIONALITY RELIGION LANGUAGES SPOKEN ENGLISH ABILITY (Low/Intermediate/High) PASSPORT NUMBER ISSUED DATE (dd/mm/yyyy) EXPIRED DATE (dd/mm/yyyy) PLACE OF ISSUE

COUNTRY

Attitude/Personality/Hobbies Have you ever traveled and stayed outside your country? If yes, where and for how long? How was your experience traveling and/or staying overseas? What are you most excited about when moving to Vietnam? What are you most worried about when moving to Vietnam?

How would you describe your personality (check all that apply)? Outgoing Tidy Independent Cooperative Quiet Studious Adaptable Personable

Enthusiastic Talkative Sensitive Motivated

What are your hobbies? What do you like to do in your spare time? Who are you currently living with? (with family/alone/roommates)

Preferences Host Family Do you prefer living with a family with small children? Do you want to stay in single room or do you want to share the room with the host? Do you have any special requirement for the room you stay in? Do you smoke? Are you willing to live around people who smoke? Are you willing to live around pets? Do you have any medical conditions or allergies? Do you take any medication? Do you require any special diet? Do you require any special diet? Would you like the option of cooking?

Family Contact Information LAST NAME FIRST NAME PHONE NUMBER EMAIL ADDRESS RELATIONSHIP TO YOU (For example: Mother/Father…)

LAST NAME FIRST NAME PHONE NUMBER EMAIL ADDRESS RELATIONSHIP TO YOU (For example: Mother/Father…)