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Would you like to host a student?
Family Name:
Given Name:
Sex:
Male
Female
Age:
Nationality:
Where are you from? (Country, City)
Home Address:
Phone:
Email:
Occupation:
Hobbies:
Arival Date:
Departure Date:
-
Room:
Single
Double
Apartment
School
Name of School:
Address of School:
Phone # of School:
Emergency Contact
Name:
Relationship:
Phone Number:
Email:
Address:
PLEASE ATTACH PHOTO OF STUDENT FOR HOST FAMILY
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