Name:         
Date of Birth:
Male:        Female:

When will you begin your study at IIE? Year:

How long will you study at IIE?  
How long will live with your host family? 
Do you have allergies or medical problems? (If "yes" please explain)
Are there any foods you cannot eat? (If "yes" please explain)

Are you:  Very neat    Average    Messy ?

Most American families ask that their host students clean their own rooms and do their own laundry. Will you do your own laundry and clean your own room?

Do you smoke?    If so, you must agree to smoke outside.

Do you use alcohol?
If so, how often?    

Will you live in a home with small children (10 years & under)?

Most Americans have pets.
Will you live with a family that has dogs?    cats? 

What are your interests and hobbies?

Do you play a musical instrument? (If "yes" which kind?)

Are you: Shy    Average   Social   Very Social?

Do you prefer a family who will take care of you    or a family will give you independence  ?

What are the most important things that your host family should know about you?

Please return this form with your application so that we can find a suitable host family for you.