Primary Applicant

First name*

Last name*

Cell Phone*

Email*

Occupation*

Please describe your work schedule*

Secondary Applicant

First Name*

Last Name*

Cell Phone*

Email*

Occupation*

Questionnaire

Home Address*

List all residents living at home (name, age, gender)*

Are there any other residents that frequent your home? (ie. babysitter, relatives, etc.) If so - please list:

Pets*

Languages spoken at home*

Does anyone in the family smoke? Do you allow smoking in your home?*

Where did you hear about the host family program?

Why do you want to be a host family?*

What is the maximum number of players you would be able to host?*

Check all that you would be able to provide a hosted player:*

Individual room

Individual bed

Individual desk

Closet

Dresser

Wireless internet

TV in home

TV in room

Bathroom (nearby)

Bathroom (same floor as room)

Nearby access to laundry

Three meals a day

Size of bed*

If the hosted player brought a vehicle, where would it park?*

Have you hosted students or players before?*

Are you currently hosting other guests/students/players?*

Does your family have any specific dietary restrictions?*

Are you willing and able to provide transportation to and from Academy trainings, matches and events?*

Yes

No

Are you willing and able to provide transportation to and from school?*

Yes

No

Which high school boundary does your house reside in?*

Additional Comments/Questions*

Submit