HOST FAMILY APPLICATION

To be completed by host family. Please complete all sections.

Family Information

Family Name:

Address:

Home Phone: ()

Home E-mail:

Father's Name:

Employer:

Position:

Work Phone: ()

Cell Phone: ()

Mother's Name:

Employer:

Position:

Work Phone: ()

Cell Phone: ()


Children

Other people living in your home:

Church Information

Church:

Do you attend: weekly? monthly? sometimes?

Pastor

Do your children attend Youth Group? yes no

Please comment on your expectations for the host student(s) to attend church services and other church activities:

HOST FAMILY PROFILE

The following information will be shared with the student and his or her family.

Home Environment.

a. Describe your family. Please mention occupation(s) of parent(s).

b. Describe a typical weekday in your family.

c. Describe any interests, activities or hobbies that your family shares.

d. Describe your neighborhood and home in as much detail as possible.

e. Describe the student's bedroom.

f. Describe any services (recreational, computers, sports facilities, etc.) that the student will have easy access to.

g. What household chores (or other) will be expected of the student?

h. Are there any non-negotiable rules in your household? Please explain.

i. Have there been any recent major changes (divorce, death, serious illness, career change) in your family circumstances? If so, please briefly describe the changes(s) and the effects on your family.

j. Are there any specific or unique requests or expectations that your family would have of the student? If so, please indicate.

k. Do you have any family pets? Please list name(s):

l. Does anyone in your family smoke? yes no

The Mission of Oak Grove

m. It is Oak Grove's mission to "express God's love by nurturing young men and women for academic achievement, lifelong Christian commitment and loving service throughout the world."
Briefly describe what you see as your family's role in working towards this mission as a host family:

n. Please write a message to your potential guest student.

Family photo
Home photo
Placement Information

1. Is your family willing to host a female male no preference.

2. Our family is willing to host multiple students. yes no

If yes, how many?

3. Has anyone in your family ever been convicted of a crime? yes no

If yes, please explain.

4. Will the student have his/her own room? yes no

5. List indoor pets

outdoor pets

6. What language is spoken in the home?

7. What other language(s) are known by family members?

8. Does your family have previous hosting experience? yes no

If yes, in what year(s) did you host?

Where was the student from?

Please list challenges and benefits of that experience.

9. Would you consider your home to be active, quiet or average?

10. Are there any dietary restrictions (i. e. adherence to strict vegetarian diet) in your family? yes no

If so, please give details.

11. Will any family member be away for an extended time during the student's stay? yes no

If yes, explain who, which dates and if this will affect hosting.

12. Please give directions to your home from the nearest major road.

13. Explain your motivation for becoming a host family.

14. Have you prayerfully considered your decision to host a student? yes no

Is your entire family in agreement? yes no