Alpine English School - Homestay Application Form

First Name

Last Name

Email

Phone

Address

Type of accommodation?

Homestay in Kimberley
Homestay near Ski Resort
Homestay in Marysville

Start Date
(usually one day before the course begins)

Arrival Flight Information:

Flight No:

Arrival Time:

End Date
(usually one day after the course ends)

Please include any allergies or medical conditions the AES staff or your host family should be aware of:

Please give us some additional information about your family:

Name	Relationship	Occupation	Birthday

Homestay preference:

Family with young children
Family with teenagers
Adults with no children
No preference

Pets:

Family with dogs:	OK Not OK
Family with cats:	OK Not OK

Do you smoke?
Please note that even families who smoke do not usually permit smoking in the house. If you are a smoker, you will likely be asked to smoke outside.

Yes No

Your food preferences:

	Like	Tolerate	Dislike
Meat
Fish
Poultry
Eggs
Beans
Rice

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Alpine English School Homestay Application Form