STUDENT APPLICATION - ECHS Teachers Homestay

STUDENT APPLICATION FORM

Students: It’s easy to book your program. First choose your desired program, then choose your destination city. Lastly tell us a bit about yourself and what you’re looking for so we can make an excellent match for you and your teacher.

Name
First Last
Email
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Program dates (if known)
Desired program
Desired City
Choose from New York, Los Angeles, San Francisco, Honolulu, Seattle, Portland, Maui, USA or Vancouver, Canada
English background/level
Profession including student
Age at time of program
Do you have health issues including allergies, depression, learning challenges, etc.
Are you comfortable with children?
- Yes
- No
Are you comfortable with pets?
- Yes
- No
Do you smoke?
- Yes
- No
Hobbies and interests
Special Requests
Include dietary needs, allergies or any other important information