.....

    DBS Held:

    .....

    DBS Held:

    .....

    Children living away from home:

    .....

    .....

    .....

    DBS Held:

    .....

    DBS Held:

    .....

    Do you have any pets?:

    Do you have Wi-Fi:

    Does anyone in the household smoke:

    ......
    Location

    Is there a frequent bus service:

    Is there a bus stop near your house:

    How far is the bus stop?:

    .....

    Accommodating students:

    Please tick which of the following types of students you would be happy to accommodate:

    Please tick which ages you would prefer:

    Can you cater for?




    Have you had students before?:

    Further Information:

    ......

    References
    Please give the names and addresses of two people who can provide a reference for you. They can be a host family, a
    friend, a work colleague, etc. You cannot use family members.

    ......

    Reference 1

    ......

    Reference 2