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Host Family Application
Thank you for your interest in serving as an FVL host family. After the form has been submitted, someone will contact you to set up an appointment for a home visit.
Host Parents
Number of Host Parents
*
One
Two
Host Parent 1 Information
Host Parent 1 - First Name
*
Host Parent 1 - Last Name
*
Host Parent 1 - Gender
*
Female
Male
Host Parent 1 - Date of Birth
*
Host Parent 1 Employer/Occupation
*
Host Parent 1 Primary Phone Number
*
Host Parent 1 - Primary Phone Number is . . .
*
Home
Work
Mobile
Host Parent 1 Phone Number 2 (optional)
Host Parent 1 - Phone Number 2 is . . .
Home
Work
Mobile
Host Parent 1 - Primary Email
*
Host Parent 1 - Primary Email is . . .
*
Home
Work
Host Parent 1 - Email 2 (optional)
Host Parent 1 - Email 2 is . . .
Home
Work
Host Parent 1 - Best way to be reached
*
Email
Phone
Either
Host Parent 2 Information
Host Parent 2 First Name
*
Host Parent 2 Last Name
*
Host Parent 2 Gender
*
Female
Male
Host Parent 2 Date of Birth
*
Host Parent 2 Employer/Occupation
*
Host Parent 2 Primary Phone Number
*
Host Parent 2 - Primary Phone Number is . . .
*
Home
Work
Mobile
Host Parent 2 Phone Number 2 (optional)
Host Parent 2 - Phone Number 2 is . . .
Home
Work
Mobile
Host Parent 2 - Primary Email
*
Host Parent 2 - Primary Email is . . .
*
Home
Work
Host Parent 2 - Email 2 (optional)
Host Parent 2 - Email 2 is . . .
Home
Work
Family Information
Address
*
City
*
State
*
Zip Code
*
School District in Which We Live
*
Airport for Arrival (with airport code)
*
Appleton (ATW)
Green Bay (GRB)
Either Appleton (ATW) or Green Bay (GRB)
Church Membership
*
Pastor(s) Name
*
Family members living in the home (please list names and ages)
*
Pets Inside Home
*
Pets Outside Home
*
Name of Emergency Contact Living Outside the Home
*
Emergency Contact Phone Number
*
Family Life / Expectations
What hobbies/recreational activities does your family enjoy?
*
Describe your home environment and family style
*
What are your expectations of this student? (household responsibilities, rules, curfew, etc)
*
Why do you want to host an international student?
*
Have you ever hosted an international student before?
*
Yes
No
How many international students have you hosted before?
*
Our family would prefer . . .
*
Male Student
Female Student
Either Male or Female
Does anyone in the home smoke?
*
Yes
No
Will the student share a room?
*
Yes
No
With whom will the student share a room?
*
Are there any health or conditions among family members that would affect the student's experience?
*
Do you or any family members (check as many as apply) . . .
*
have an arrest or conviction record
have a complaint filed with an agency concerning child neglect or abuse
currently have an ongoing issue with drugs/alcohol/illegal substances
none of these
How far do you live from FVL?
*
How will the student get to FVL?
*
How would special accommodations for cocurriculars be arranged?
*
Signature
Thank you for completing this form. Please note that completion of this application does not confirm the placement of a student in your home.
Host Parent 1 Signature
*
Host Parent 2 Signature
*
Date Submitted
*
+
Please click "Submit" to complete the application.