2015-2016 Amity Intern Host Family Application Please print. The more flexible you are the better your chances for hosting. Please return completed application to the PTA box in the school office or e-mail to amity@puestadelsolpta.org by May 1, 2015. Attach additional sheets as necessary. Questions? Go to www.amity.org for more information. Family Name: ____________________________________ Please list names, ages and relationship of all living in the home: _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Preferred host dates: Any time ___Late Aug-Nov___ Dec-mid March ____Mid March-June _____ Would take Intern on vacation during these time periods? (not required) Yes __ No ___ Maybe ___ Preference: Male or Female Intern _____ Male Intern Only _____ Female Intern Only _____ For adults, please indicate outside of home work status, place of employment, type of work, and owner or employee status. _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Do all school age children attend Puesta del Sol? Yes _____ No _____ If not, please list school(s) attended: ___________________________ Is there shared child custody? Yes ____ If so, please attach the schedule. Interns must remain living in one home during their 3-month stay with a family and will not move with children between homes. Pets? Type/Size: _________________________________________________________________________________ Languages spoken at home: _________________________________________________________________________________ Phone: ______________________________ Email: _______________________________________ Address: __________________________________________________________________________ Transport to school: Bus_____ Car _____ Other _____ describe: _____________________________ Previous host? Yes _____ No _____ If so, when/name of Intern______________________________ Intern requires a private bedroom. Please attach a description of your home and living arrangements. Please attach an explanation of why you would like to host an Amity Intern. Describe your expectations, anticipated benefits to your family, challenges you anticipate, and any previous experience with international visitors, travel, etc. Describe your family, including personality, types of activities you enjoy, things you might do with your Intern, etc. Describe a typical day in your household. What are your concerns, questions or additional comments?
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