Host Family Application Form 2025

PERSONAL INFORMATION

First Name*

Surname*

Street Address*

Email address*

Phone Number*

First or Native Language

Adult Host #1

Full Name*

Date*

Occupation*

Does this individual have a DBS from the past 12 months?*

Yes

No

Not sure

Adult Host #2 (if applicable)

Full Name

Date

Occupation

Does this individual have a DBS from the past 12 months?*

Yes

No

Not sure

Phone Number*

CHILDREN

Are there children (under 18s) living in your home?*

Yes, full time

Yes, part time

No

Please list the name and ages of any children living at the home.

YOUR HOME

Do you have Wi-Fi?

Yes

No

Do you have pets?

Yes

No

Does anyone in your household smoke cigarettes?

Yes

No

How many bedrooms do you have available for students?

How many beds do you have available for students? (more than 1 per room is fine)

LOCATION

Approximately how far is your home from Cheltenham town centre?

How long would it take to walk from your home to Cheltenham town centre?

Is there a frequent bus service near your home that goes to Cheltenham town centre?

Yes

No

Not sure

REFERENCE 1

Name*

Occupation*

Relationship*

Phone*

Email address*

REFERENCE 2

Name*

Occupation*

Relationship*

Phone*

Email address*

Please type the characters*

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