First Name

Last Name

Gender GenderMaleFemale

City

Street

House-Apt Number

County

Postal Code

Country

Email

Cell Phone (example: +40-722-222222)

Current School

Currently Enrolled in Grade Currently Enrolled in Grade9101112

Area of study at your current school (math, biology, humanities)

Please select your academic interest level so that we can better align your University and High School class visits. Choose from the following options: Please select at LEAST TWO (2) but no more than three options. Please select your academic interest level so that we can better align your University and High School class visits. Choose from the following options: Please select at LEAST TWO (2) but no more than three options. Business Administration (global business, management) Marketing/Communications Finance/Economics/Accounting Art/Music Archaeology/Anthropology Biology/Chemistry/Biochem Medicine/Physical Therapy Athletic Training/Exercise Science Nursing/Laboratory Science Creative Technologies Innovation/Changemaking Education Environmental Science Mathematics/Physics Political Science/International Relations History Theatre Engineering (Civil/Mechanical/Electrical) Computer Science/Computer Engineering Other (please specify)

If you selected the Other field, please specify here

Extracurricular activities (in school or outside of school)

Your Native Language

Other languages that you speak or study/studied

Number of years you have been learning English

In your opinion, your current level of English language ability In your opinion, your current level of English language abilityBeginnerIntermediateAdvanced

Hobbies -what do you love doing in your free time? Tell us about yourself

Sports you enjoy playing or watching

Please describe yourself with three adjectives - i.e. outgoing, adventurous, etc.

Do you have pets at home? If yes, what kind?

Do you have any dietary restrictions - i.e. gluten/dairy?

Do you have any allergies - if yes, please list/describe?

Mother's First Name Parents’ Information

Mother's Last Name .

Mother's Occupation/Background

Mother's Email

Mother's Cell Phone

Father's First Name

Father's Last Name

Father's Occupation/Background

Father's Email

Father's Cell Phone

In Case of Emergency, we should contact: Mother? Father? Someone else? Please Describe and provide cell phone number

Other family members Please list other family members living in your home - i.e. siblings, etc.

Please write a short paragraph to your Host Family - 1 paragraph. You might want to share details about yourself, your family, school, activities you are involved in, and your community. Additionally, expressing your hopes and enthusiasm for this experience, as well as any other information you believe would interest the host family, would be beneficial as they learn more about you and your family. Student’s Personal Letter to the Host Family

Upload picture of your family here Next, please submit a photo of you/your family that we can share with the host family. This photo will not be shared with anyone else.File InputChoose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, gif, png, bmp, tiff, tif, webp, avif, heic, heif, webm, pdf, rar, doc, docx, odt. Max. file size: 4 MB