Host Family Application

Name

Date of Birth

YYYY

Phone

Occupation

How did you hear about us?

Email:

Mailing Address

How long have you lived in Santa Barbara?

Previous address outside of Santa Barbara (if applicable):

Other people residing in the home (please include occupations and dates of birth):

Please select

Have you hosted international students before?

Please select

Please select

Pets:

None

Pets Inside

Pets Outside

Distance to SBCC from host family home and bus route number:
All host families must be within 10 miles of SBCC and downtown Santa Barbara.

Do you smoke?

Yes

Will you accept a student who smokes?:
All students who smokes must smoke outside only unless approved by the host family.

Yes

Internet in home:
Having internet accessibility is a requirement to host.

Wireless

Cable

Other

Laundry availability:
Laundry availability is a requirement to host. Rules and regulations are up to the host family.

At students' discretion

Available once a week

Host family will do laundry

How do you spend your free time and what activities will students be included in?

Please list any dietary restrictions and specific eating habits in your home:

Anything else you would like to add about your family:

Personal reference and relationship to you:

Reference phone number:

Has anyone in the house been convicted of a crime?

Has anyone in the house ever been convicted of selling, distributing or manufacturing illegal drugs?