SUSPENDED FORM

Host Family Name

Application Date

Address

Mothers Name

Mothers Cell Phone

Family Home Phone

Mothers Email

Mothers Occupation

Mothers Occupation Type
Check any that apply.

Full Time‎ Part Time‎ Inside Home‎ Outside Home‎

Fathers Name

Fathers Cell Phone

Fathers Email

Fathers Occupation

Fathers Occupation Type
Check any that apply.

Full Time‎ Part Time‎ Inside Home‎ Outside Home‎

Child 1

Gender

Age

Child 2

Gender

Age

Child 3

Gender

Age

Child 4

Gender

Age

Child 5

Gender

Age

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Which of the following may your student use in your home?
Check all that apply.

Which facilities are close to your home?
Check all that apply.

Is your home?

Do you own/rent/visit any recreational facilities in the summer?
(i.e. summer cottage, boating facilities, etc.) If so, please describe and identify whether student will be able to participate.

Please list individual family interests/hobbies.
i.e., karate, ballet, soccer, baseball, reading, etc.

Please list shared family activities.
i.e., hiking, jogging, picnics, skiing, board games, sports, camping, music, etc.

What types of meals are prepared in your home?
Kindly detail any foods that you will not prepare and why.

Is anyone in your home a vegetarian?
Choose One.

Please indicate your families religion describe your level of involvement.
i.e., Active, Casual, Holidays, Etc.

Will your student be expected to attend services with you?
Please choose preference.

Do you have any pets?

If yes, please list type, breed, size and if they are indoor/outdoor or both.

In addition to keeping his/her own personal area clean, what household duties will you expect of your student?
Check all that apply.

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What type of student would you prefer?
Please choose preference.

What age would you prefer your student?
choose all that apply

10-12‎ 13-15‎ 16-18‎ No Preference‎

Would you be willing to host a student who speaks little or no English?

Please provide two local references that are familiar with your household.
Include name, phone number and/or email and please describe your relationship to references.

Have you hosted a foreign exchange student before?

Do you know of anyone else who might be interested in hosting a foreign exchange student?

How did you hear about Bonjour Chicago and whom may we thank for referring you?
i.e., Name, Address, Phone, Email

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Please write a brief one page letter introducing your family to your student.
To insure your student choice, please submit your family application immediately. Your family introduction letter and upload 3 photos (.jpg, .gif) (.doc, .txt, .pdf).

Upload personal Photo's

Add files

Drop files here to add

Upload Family Photo

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Upload Misc Photos

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Terms of Service

I agree to the terms of service.

Digital signature
IMPORTANT! Once you complete your signature, please scroll down to the next page and click SEND to submit your application. Thank you.

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This section for Internal Use Only - To be completed by Bonjour Chicago.

Approved by
To be completed by Bonjour Chicago

Office Use Only - Name of Student

Hosting Family
To be completed by Bonjour Chicago

Arrival Date

Arrival Time

Arrival City, Airline, Flight No.

Departure Date

Departure Time

Departure City, Airline, Flight No.