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International
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Host Family - Student application
Host Family - Student application
More in this Page
Resources
Orientation and Registration Confirmation
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Host Family application
Host Family - Student application
International Ambassador Application
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International Students: Transfer Out Request Form
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Student Information
First Name
Last Name
Date of Birth* (Fill in by DD/MM/YYYY. Example: 25/01/1991)
Address
Trine Email
Personal Email
Cell Phone
How often do you check your email:
Daily
Weekly
Monthly
Marital Status
Single
Married
Gender
Male
Female
Emergency Contact Information from home country(parent/guardian preferred)
Last (Family) Name*
First (Given) Name*
Relationship (example: mother, father, brother, etc)
Address
Home Telephone
Business Telephone
General Information
How did you hear about us?
Orientation
Trine Faculty/Staff
Friends/Family
Social Media (Facebook, etc.)
Trine Website
Other
Level of study
Short term program
ESL
Undergraduate
Graduate
Spouse
Major
Duration of Stay (approximate)
Short term program
One semester
One year
Two years
Three years
Four or more years
Country of birth
Country of citizenship
What is your visa category?
F-1 ESL student
F-1 Degree student
J-1 student
J-1 Scholar
B-visitor visa
Esta - visitor visa
Please mark your host family preference
Family
Married Couple - no children
Single Female
Single Male
No Preference
List hobbies and things you are interested in doing outside of campus
Why are you interested in the Host Family Program?
What do you feel you will get from this program? How will it benefit you and your host family?
Personal Information and Preferences
How would you rate your English skills?
Poor
Fair
Good
Excellent
Do you smoke?
Yes
No
Would you be okay to visit a home where members of the host family smoked?
Yes
No
Do you drink alcohol?
Yes
No
What is your health condition?
Excellent
Good
Fair
Poor, please explain below
If you marked poor in the question above, please explain
Are you currently on any kind of medication or have any health problems that your homestay family should be aware of?
Do you have any allergies?
Is there any type of food that you cannot eat due to dietary or religious reasons?
Are there any types of food that you do not like?
Are you allergic to any pets?
Submit
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