Host Family Application
Thank you for taking the first step to become part of our global family.  You will need to fill out the below application.   A Housing Coordinator will contact you after your application has been reviewed.
Host Applicant

First Name:

Last Name:

Host Sex:

​DOB:

Home Address:

Home City:

Home State:

Home Zip Code:

Home Phone:

Cell Phone:

Email Address:

Employer:

Employer Phone:


Host Family Home​

Home Description:


List Other Home Occupants:

Prior Hosting Experience:

Languages Spoken in Home:

Hobbies and Interests:

Is your home non-smoking?

Children in the home?

Approximate ages?

Do you have pets?

Do your pets live indoors?


Spouse Information

Spouse First Name:

Spouse Last Name:

Spouse Sex:

Spouse DOB:

Spouse Employer:

Spouse Employer Phone:


Student Request

Do you have a student gender preference?

Will the bathroom be private or shared?

Do you have WiFi internet?

Please select the preferred meal plan:

How many bedrooms do you have available for students?

Do you ave any specific student requests?








Authorization for Background Check


By checking the above background authorization box, you authorize Homestay of Long Beach permission to screen your background for criminal and sex offenses, which may confirm or deny, your eligibility to provide host services to homestay students through our agency.  You fully understand Homestay of Long Beach utilizes an outside agency to provide this information.  Your authorization shall remain in effect until written notice is received to terminate the authorization and all host agreements with Homestay of Long Beach.



HOMESTAY OF LONG BEACH

562-269-4606

I agree
MaleFemale
YesNo
YesNo
YesNo
MaleFemale
PrivateShared