Host Family Online Application

Host Family Last Name

Host Family First Name

Please enter your legal first name (no nicknames or abbreviated names)

Host Family Phone Number

Host Family Work Number

If none, write N/A

Host Family Mobile Phone

Host Family Address

City

Zip Code

Is the physical address the same as mailing address?

Yes

No

Host Family Email Address

Host Family Employer

Host Family's Employment Status

Have you worked for BYUH before?

Yes

No

Have you been dismissed, asked to resign, or left by mutual agreement from any position?

Yes

No

Spouse's First and Last Name

Spouses Occupation

Please list each person in your household (adults and children)

Family Pets?

Yes

No

Primary Language Spoken at Home

Secondary Language Spoken in Home

Religious Affiliation

LDS

Non-LDS

If LDS, provide ward & stake information

Homestay Accommodations

Program requires each guest(s) to have their own bed. Student(s) are not allowed to share futons, double, queen, or king size beds. Private = student has his own room. Shared = 2-4 students share the room not a bed.

Gender Preference

Male

Female

No preference

Number of Guests Applying to Host

Program requires each guest(s) to have their own bed regardless if the bed is a queen or king size. If a family wishes to host 4 guests, the family must have 4 separate beds to qualify to host 4.

Programs

Select all that apply

Winter (Jan-Feb)

Summer (July-Aug)

Other

Home Inspection Date Preferred

Home Inspection Time Preferred

References

(List 3 individuals who know your work professionally)

Agreement

Host Family Agreement
1. As a Host Family you agree to do all you reasonably can to ensure the safety of your ESL students. Host families are responsible for the well-being of each ESL student (i.e. safety, emotional health, fiscal, etc.). Host families are also responsible in contacting the ESL Coordinator and local authorities (HPD, Hospital, etc.) for all incidents related to the safety of the student. 2. As a Host Family you agree to supply your homestay students with a clean bedroom, their own bed, and all necessary linens and towels. (ESL students may share a bedroom with your child/children but not a bed.) Students should be made comfortable and have freedom to use the home and not be confined to a room. 3. Laundry facilities will be provided by the Host Family. You may choose to do the laundry for the ESL students or decide whether the ESL students will do their own laundry. Please remember that most of the ESL students do not know how to use a washer and dryer. Please take the time to teach them. 4. The ESL students will be provided with three nutritious meals each day, as required (please refer to the program itinerary). EO will provide lunch for the ESL students during the week and when an all-day excursion is scheduled. The Host Family will provide breakfast and dinner (please refer to the program itinerary). 5. The Host Family will provide transportation to and from school. Please be punctual to drop off and pick up your ESL students on time. Do not allow your ESL students to walk home alone after dark. You may choose to arrange a car pool with other host families. 6. Plan to spend time with your ESL students, include them in your family activities and conversations and, if possible, take them on a special outing. Make their stay in the United States a memorable one. 7. Host Families should plan to attend orientation, receptions, award ceremonies, and any ESL Program-sponsored dinner or activity to which they are invited or required to attend. These are important times when all host families and homestay ESL students can enjoy time together. 8. If you are not in the home, do not allow your ESL student’s to stay in your home overnight by themselves. ESL students are not to be left home alone or with a minor. If you are going to be away overnight and the ESL student is not going with you, please contact JJ Huang (808) 393-1469. 9. Host Families agree not to allow visiting guests to stay overnight while hosting ESL students at any time. 10. Host families should not ask your ESL student(s) to babysit for you! 11. ESL students are invited and encouraged to attend church services with the family. No pressure is to be exerted upon ESL students to convert to the religion of the host family, but ESL students are expected to respect the moral standards and religious practices of the family. ESL students who attend church should be encouraged to bring a notepad and make lists of new words they hear each week, to read words and follow along in the hymns, or to take notes. If questions or concerns arise regarding church attendance, please contact the Program Coordinator. 12. Host families are responsible for any illegal actions performed against the ESL student. In the event there is questionable behavior on the part of a family member, the ESL student will be removed from the Host Family immediately. Host families should immediately notify JJ Huang at (808) 393-1469 if any problem or emergency arises and local authorities if applicable. 13. If you have any concerns or problems, you are to contact the JJ Huang. Please understand that an ESL student may request a change of homestay family and that the family may request an ESL student to be changed if, after sufficient time has elapsed, they find they are not compatible. 14. The Host Family will receive compensation per ESL student per day. JJ Huang will inform you of the date and arrangements for you to receive your compensation. Payment or fees should not be a topic of discussion with the ESL student. I agree to be fully bound by the terms and conditions of participation in the ESL Host Family Program as outlined in this agreement.

Dress Code and Grooming Standards
Appropriate for men (Classroom & General Campus Wear) •Slacks, jeans, dress shorts, sweaters, and sport or dress shirts with sleeves. •If worn, neat mustaches which do not extend beyond or below the corners of the mouth. •Neat hairstyles, trimmed above the collar and leaving the ears uncovered. •Clothing which cover the knee. •Clean-shaven appearance, modest sideburns. •Footwear worn in all public places. Men must wear shirts at all times. Appropriate for women (Classroom and General Campus Wear) •Dress, loose-fitting blouses, shirts and sweaters with sleeves. •Modest, neat hairstyles. •Skirts, gaucho, modest pantsuits, jeans and slacks to the waist. Hemline on dresses, skirts, and shorts must cover the knee. •Footwear worn in all public places. Appropriate Work-out or Athletic Attire •Swim suits are modest in fabric, fit and style (no bikini, two-piece or French-cut styles) •Modest shorts, sweats, and appropriate gym clothing. •Modest t-shirts which cover the back, midriff and arms. •Appropriate footwear in all athletic areas. Inappropriate for men (Classroom & General Campus Wear) •Any sleeveless clothing and clothing that exposes the underarm and waistline. •Any athletic shorts, sweats, or surf shorts. •Earrings or excessive jewelry. •Beards or noticeable (grubby) facial hair. •Body piercing. •Visible tattoos. •Hats, caps, or beanies indoors. •Bandanas. Inappropriate for women (Classroom & General Campus Wear) •Dresses or skirts with lists above the knee. •Tight clothing and leggings. •The no-bra look. •Any sleeveless clothing or clothing that exposes the underarm and midriff. •Evening or formal wear with low-cut necklines, or gowns that are backless, strapless, or which have spaghetti straps. •Any athletic shorts and sweats. •Excessive hairstyles or colors. •Excessive ear-piercing (not more than one pair on lower earlobes) •Body piercing. •Visible tattoos.

Assumption of Risk and Release Agreement
I, the applicant, recognizing the hazards and dangers inherent of said activity(s) and/or in the transportation to and from such said activity(s) and already knowing or having been advised of said dangers and fully acknowledging the risk of injury or health inherent therein, whether by my own actions, the actions of others or events beyond my control, do hereby agree to knowingly and voluntarily assume, full responsibility for all of the risks surrounding my participation in said activity(s) and any other activity(s) undertaken as an adjunct thereto, and all risks associated with my own health problems and physical or emotional limitations; I also certify that I am covered by my own health insurance; and, furthermore, for myself, my heirs, and personal representative(s), I hereby fully release Brigham Young University–Hawaii and all its officers, employees and agents, without any limitation or qualification, as to any and all liabilities, claims, demands and actions which might be made by me or my state on account of any losses, expenses or damages of any kind concerning property or personal injuries (physical or emotional) or death which may result, directly or indirectly, from my participation in the aforesaid activity(s), unless any such damages or injury is primarily the direct result of a negligent act or omission by Brigham Young University–Hawaii or any of its officers, employees or lawful agents and not caused in part by my own negligence.

As the applicant, I affirm that I have carefully read these agreements (the host family agreement, Youth Protection Policy, BYUH Honor code dress and grooming standards, Assumption of risk and release agreement) and understand its contents and purposes, and voluntarily agree to all the terms set forth above. Furthermore, I will be responsible in ensuring my family reads these requirements and understands its contents and purposes and agrees to all the terms set forth above. I understand the submission of this application does not guarantee acceptance as a host family. I understand my preferences will be considered, but is not guaranteed to be met every time.

Agreed

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