Swedish Program Application

Please fill out this form as completely as possible. The fields with an asterisk by them are required. Once you click the Submit button at the bottom, it will generate an email with your responses. You should be notified within 2 business days of your acceptance into the program this year, and you'll also at that point receive the information that will allow you to access the students' letters and videos.

If you have any questions or problems with this form, please contact me.

Deborah Nelson

dnelson@santarosa.edu

(Primary Applicant) First Name

(Primary Applicant) Last Name

(Second Applicant) First Name

(Second Applicant) Last Name

Home Address

Home Address (City)

Home Address (Zip)

Primary Applicant Cell #

Secondary Applicant Cell

Home Phone

Primary Applicant Email

Secondary Applicant Email

Primary Applicant Gender

Secondary Applicant Gender

Primary Applicant Age

Secondary Applicant Age

Primary Applicant Occupation

Secondary Applicant Occupation

Primary Applicant Interests/Hobbies

Secondary Applicant Interests/Hobbies

Also living in the home 1 (first name, age)

Also living in the home 2 (first name, age)

Also living in the home 3 (first name, age)

Also living in the home 4 (first name, age)

Pets (names, breeds, ages)

Does your home have a private bedroom for the student?

Yes

Does your home have Wi-Fi Internet access that the student can use?

Yes

How does your family plan to provide transportation for the student to/from school (weekdays and occasional weeknight/weekend group activities)? Please check all that might apply.

Family member will drive

Student will take the bus

Student will walk

Student will ride a bicycle

If student may ride bus, how far is nearest stop from your home?

What is the route# (if you know it) from that stop?

Smoking permitted in home?

Yes

Prefer male or female student?

Male

Female

Either

If needed, would your family be willing and able to host a second student?

Yes

Maybe

Note

It's possible for Swedish students to share a bedroom with each other is the size/arrangements are adequate.

Please describe any other activities (not listed above) your family enjoys regularly or plans to do with your student.

Has your family ever hosted a foreign student?

Yes

If you said you have hosted a foreign student before, tell us what you liked or disliked about that experience.

How did you hear about this program?

Is there anything else you'd like to tell us about your family, interests, or comments regarding the program?

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