If you are interested in hosting students from Punta Arenas during their exchange to Bellingham, please print out the following form, fill it out completely, and send it to the address indicated at the bottom of the page.

BELLINGHAM SISTER CITIES ASSOCIATION

HOMEHOST APPLICATION

Punta Arenas, Chile Student Exchange Program

Please complete all questions. This information will help us match a student or other visitor for placement in your home.

1. Contact Name:

2. Today’s date:

3. Your Age                             Birthdate                                                          

4. Male              Female         

5. Permanent Address:     

6. Home Phone Number:

7. Work number:

8. Number of people in your family?

9. Please list their names, ages and relationship to you:

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10. List the countries you have visited

11. Language(s) you speak and degree of proficiency:

12.Hobbies/Interests/Sports

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13. Occupation/Professional Goals:

14. Dates you are available for hosting:

                           (beginning date)                                   (ending date)

15. Do you smoke?                                           

16. Would you allow someone to smoke in your home?                                      

17. Do you have pets?               What type of pets?

18. What accommodations do you have available for a visitor?

19. Have you hosted someone before?                      Who and when?

20. How many visitors can you accommodate at one time?

21. Would you prefer to host a male or female visitor?            

No preference         

22. How will the visitor get to the planned activities for the group?

23. What activities might you and your family do with a visitor?

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24. Personal references:

Name                                                                         Phone                                                           

Name                                                                         Phone                                                             

Send this form to: XXXX