2015-2016 Amity Intern Host Family Application

2015-2016 Amity Intern Host Family Application
Please print. The more flexible you are the better your chances for hosting. Please return completed
application to the PTA box in the school office or e-mail to [email protected] by May 1, 2015.
Attach additional sheets as necessary. Questions? Go to www.amity.org for more information.
Family Name: ____________________________________
Please list names, ages and relationship of all living in the home:
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Preferred host dates: Any time ___Late Aug-Nov___ Dec-mid March ____Mid March-June _____
Would take Intern on vacation during these time periods? (not required) Yes __ No ___ Maybe ___
Preference: Male or Female Intern _____ Male Intern Only _____ Female Intern Only _____
For adults, please indicate outside of home work status, place of employment, type of work, and
owner or employee status.
_________________________________________________________________________________
_________________________________________________________________________________
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Do all school age children attend Puesta del Sol? Yes _____ No _____ If not, please list school(s)
attended: ___________________________ Is there shared child custody? Yes ____ If so, please attach
the schedule. Interns must remain living in one home during their 3-month stay with a family and will
not move with children between homes.
Pets? Type/Size:
_________________________________________________________________________________
Languages spoken at home:
_________________________________________________________________________________
Phone: ______________________________ Email: _______________________________________
Address: __________________________________________________________________________
Transport to school: Bus_____ Car _____ Other _____ describe: _____________________________
Previous host? Yes _____ No _____ If so, when/name of Intern______________________________
Intern requires a private bedroom. Please attach a description of your home and living arrangements.
Please attach an explanation of why you would like to host an Amity Intern.
Describe your expectations, anticipated benefits to your family, challenges you anticipate, and any
previous experience with international visitors, travel, etc.
Describe your family, including personality, types of activities you enjoy, things you might do with your
Intern, etc. Describe a typical day in your household. What are your concerns, questions or additional
comments?