Host Family Application

QUESTIONS
Why do you want to be a host family for Eastern Christian School?
What experience has your family had experiencing and adjusting to other cultures?
How do your children feel about the family decision to host a boarding student?
How do you plan to motivate and encourage your boarding student?
Has your son or daughter had any disciplinary difficulty? Please explain.
How do you plan to support your own family’s growth while simultaneously hosting a boarding student?
If you are invited to host a boarding student at Eastern Christian School next year, what factors are important to you in deciding to fulfill the responsibility?
Do you have any concerns about hosting an International Student?
Are you willing to handle any conflicts or challenges that might arise when the boarding student is in your home in partnership with EC while maintaining a high level of confidentiality?

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CHURCH/RELIGIOUS AFFILIATION
Home Church*
Are you:*
- Member
- Attending
Denomination:*
Address*
Street Address City State ZIP Code
Pastor's Name*
Phone (including area code)*
Family's Church Attendance*
- Weekly
- Frequently
- Infrequently
We request that the International Student attend an area church’s youth group during his/her stay. Would this be a problem for you?*
- Yes
- No
- Not Sure

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FAMILY PROFILE
Do you have pets?*
- Yes
- No
Please list what type(s) of pets:*
Are any second languages spoken in the home?*
- Yes
- No
Please list what language(s):*
Will your student have to ride the school bus?*
- Yes
- No
How many miles from school do you live?*
Would you be able to provide a ride for after-school sports?*
- Yes
- No
List your family activities and interests:*
Please think over the basic rules of your household-include as much detail about the duties and responsibilities you will expect from the student. Chores/Responsibilities expected of the student:*
Curfew for weekdays:*
Curfew for weekends:*
Comments on curfews (if any):

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REFERENCES
Please list 3 references below whom we may contact in regard to our consideration of your participation in our host family program at Eastern Christian School. Please do not use family as references. Please list people who know your family well.

Three references: Two Character References & Pastoral Reference
Name*
Relationship to you*
Phone (including area code)*
Email*
Name*
Relationship to you*
Phone (including area code)*
Email*
Name*
Relationship to you*
Phone (including area code)*
Email*
HOST FAMILY PICTURES
Your International Student will be very excited to receive photos of your family. Please email pictures to Cathy Lagerveld at cathylagerveld@easternchristian.org of the following: Your Family, Outside of Your Home, Living Room/Den, Kitchen, Bedroom Where Student will Sleep, Bathroom
PARENT SIGNATURES
Date
Mother's Signature*
Father's Signature

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FAMILY INFORMATION: FATHER