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Family details
Last name(s)
Address
City
Zip code
Home Phone
Cell phone
Work phone
Fax Number
Email Address
Host Parent(s)
First Name
Gender
Male
Female
Occupation
Interests
Age
Level of education
High school
Undergraduate
Masters
PhD
Specialized diplomas
Country of birth
Mother tongue
Other languages
Religion
First Name
Gender
Male
Female
Occupation
Interests
Age
Level of education
High school
Undergraduate
Masters
PhD
Specialized diplomas
Country of birth
Mother tongue
Other languages
Religion
Children
First Name
Gender
Male
Female
Interests
Age
First Name
Gender
Male
Female
Interests
Age
First Name
Gender
Male
Female
Interests
Age
First Name
Gender
Male
Female
Interests
Age
Accomodation
I am interested in offering:
Homestay
Rent-a-room
What kind of accommodation can you offer?
How many rooms do you have available?
Do you smoke?
Yes
No
Do you have any animals?
Yes
No
If yes, Please specify
Do you have any physical handicaps?
Yes
No
If yes, Please specify
Do you own a computer?
Yes
No
Wireless internet connection?
Yes
No
Language spoken in the home:
Does your family have any special interests?
How would you travel to downtown?
Travel time in minutes:
Why do you want to take a foreign student in your home?
How did you hear about Minerva Homestay?
Advertisement
Internet
Friend
Please specify (Name of paper, website, friend)
I have read Minerva's webpage "Become a host":
Yes
No
If I/we are accepted as Minerva host(s), we agree to provide Minerva with a Good Conduct Certificate for the adult members of our family.
Thank you! Your request will be processed soon.
