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Homestay Application Part 1
1. Choose one of the following Homestay options:
(Please note, you must be at least 18 years old to participate in this program.)
2. Please provide the following contact information:
First Name:
Last Name:
Street Address:
Address (con’t):
City:
State / Province:
Zip / Postal Code:
Country:
Home Phone: FAX:
E-mail:
3. Please provide your arrival and school information:
Arrival date in Portland:
Airline / Flight Number:
Arrival Time:
Where will you study?:
School start date:
How long will you stay in the U.S.?:
Do you plan to have a car during your homestay? No Yes
4. Please describe yourself:
Date of Birth:
Gender:
Passport Number:
Nationality:
Native Language:
Do you practice religion?
If Yes, which one?
Do you smoke?
please note that you will not be permitted to smoke in most homes
Do you enjoy children (under age 6)?
Are you allergic to animals?
If yes, which ones?
What is your English Conversation Level?
Have you ever been to a foreign country?
If yes, where?
5. Tell us about your interests, activities and personal information:
What are your favorite hobbies & activities?:
List any foods that you cannot eat, allergies, health problems, etc. (if any):
Is there any other important information we should know about you?
How did you learn about this program?
Remember to click the "Send Application" button below:
A confirmation message will appear when your application has been successfully received.
You may print the confirmation page for your records.
You will receive a confirmation by email within 48 hours.
By clicking the send application button below you are providing a digital signature that
authorizes your school, indicated above, to release information to ANDEO regarding the
status of your acceptance to, or enrollment in courses at the school.
REMEMBER - YOU'RE NOT FINISHED YET...
Go to Part 2
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