Student Homestay Application

The number of host families are limited, so please apply as early as possible.

A NON-REFUNDABLE check or money order payable to OvECS to cover placement and processing fees must be sent with 2 passport size photos after complete this online application (See fees & costs).

A REFUND CAN NOT BE MADE ONCE WE BEGIN THE APPLICATION PROCESS, however, if a suitable host cannot be found, your placement and processing fees will be completely refunded to you.

When will you be starting school? Name of School

Family Name: First Name: Middle name:

Present Address: City:

State/Province/Prefecture: Zip/Postal Code: Country:

Phone: E-mail (Fax): Nationality:

Date of Birth:(month) (day) (year) Male: Female: Religion:

Last School attended or School you are currently attending:

Degree or Deploma earned & Field of Study:

Are you a currently a student? Yes: No: (occupation)

Parent’s Address: City:

State/Province/Prefecture: Zip/Postal Code: Country:

Phone: E-mail (Fax):

Father’s Name : Occupation:

Mother’s Name: Occupation:

Brothers and Sisters:

1.Name: Age: Male: Female: 4. Name: Age: Male: Female:

2.Name: Age: Male: Female: 5. Name: Age: Male: Female:

3.Name: Age: Male: Female: 6. Name: Age: Male: Female:

How did you learn about OvECS homestay program?

How long do you plan to stay with hostfamily?

What will you study in the States, and for how long?

Entry Level: ESL 2 year college Bachelor Master Ph.D. other

Interests/Hobbies/Sports: Can you swim? Yes: No:

Previous Trips Abroad:

Have you participated in a Homestay program before? Yes: (describe) No:

Personality : Outgoing: Shy: Independent: Quiet: Energetic: Sociable:

Optimistic: Cheerful: Tidy: Serious: Talkative: Modest:

Adventurous: Affectionate: Curious: Others:

Do you smoke? Yes: No: Do you drink alcohol? Daily: Sometimes: Rarely: Never:

Is it OK for family to have pets? (Dog) Yes: No: (Cat) Yes: No:

Will you have a car in the U.S.? Yes: No: Will you have a student visa? Yes: No:

What do you hope to learn from your Homestay?

Please write us something about yourself:

Name any medications you must take regularly:

Please list any allergies (food, animal, plant), health problems or any dietary restrictions:

If available, list the name of a local person to contact in case of emergency:

His / Her Address: Phone:

Signature of Applicant Date / /

Signature of Parents(if applicant is under 18)