Student Homestay Application - IHPSHomestays.com

- Step 1 of 8

1. Student Homestay Application

IHPS placement/matching fee: $385-$475; Housing Deposit: $100 (If we cannot place you in a homestay, these fees will be refunded)

Please choose one: *

I am an international student- $385
I am a US student- $385
I am an Intern- $475
I am a high school student- $475

Name *

First

Last

Date of birth: *

Age: *

Gender: *

Email *

Confirm Email

Passport Number: *

Permanent Address: *

City: *

State/Province/Prefecture:

Country *

Postal Code:

Telephone: *

Emergency Contact Information

In case of an emergency, please contact: *

First

Last

Phone: *

Email *

Confirm Email

2. Agent Information: (leave blank if you are not an agent)

Name

First

Last

Phone

3. Housing Preferences

Requested homestay housing options: *

Private room with meals
Private room without meals

Requested check in date: *

If you do not know your exact date, please list a date that is close to when you would like to check-in to homestay.

How long do you need homestay housing? (Please note: you can always extend housing if needed and your hosts are in agreement.) *

4 week Art Center (prior permission needed)
12 weeks
16 weeks
20 weeks
24 weeks
Academic year

Regular Program Students Only: I understand I am committed to 12 weeks of homestay. I understand I can give notice to move out or extend on my 8th week of housing. Extensions and move out notices must be in writing and emailed to IHPS Homestays by your 8th week of housing.

I understand

Name of school you will be attending: *

Or Address of internship:

Major of study:

If you have a major of study, please list it. If you are studying English, please list ESL.

Are children ok in the homestay? *

Are animals Ok in the homestay? (please note: most US households have pets) *

Will you have a car in the US? *

4. Medical Information:

Do you consider yourself in good health? *

Do you have allergies? *

If you have allergies, please list your allergies here:

Do you take medication? *

If you take medication, please list the medication you take here:

Are you a smoker? (Please note: there is a strict no smoking policy in our homestay program.) *

If you are a smoker, do you agree to not smoke in or around the host's home?

I understand if I am caught smoking in or around the host family's home, I will be asked to leave the homestay immediately and no refund will be expected.

Please explain any other medical information you would like your host family to know:

5. Please tell us about yourself:

What is your English ability? *

Poor
Fair
Good
Excellent

Do you speak another language? *

If yes, please list the languages you speak below:

Have you lived in homestay before? *

If yes, please explain.

What are your hobbies and interests? *

Please describe your family life at home. Do you have siblings? What do you like to do in your free time? *

Have you traveled to the US before? Please list any travel experience. *

Please feel free to share any other information with your host family here:

6. Optional Airport pick up service:

"Meet and Greet" service at the airport. IHPS drivers meet students after they clear customs inside the terminal or at baggage claim for domestic travelers.

Do you need airport pick up? (Optional: $175 fee for most airports. Santa Barbara, NYC, NJ areas please email us for a quote) *

Date of Arrival:

Airport:

Airline:

Flight number:

Time of arrival:

7. Student Housing Contract:

Please upload your student picture, and print and copy our agreement for your records: https://ihpshomestays.com/wp-content/uploads/2024/01/Student-Housing-docs-2023.pdf

Click or drag a file to this area to upload.

I understand that I am committing to at least 12 weeks of housing. If I want to extend or move out, I will notify IHPS and my hosts in writing by my 8th week of housing. *

I understand, accept and agree to IHPS Homestays' Housing Agreement.

Name *

First

Last

Date

If you are under the age of 18 years old, your parent or guardian needs to sign here:

Name

First

Last

Date

8. Homestay Application Fees:

In order to process your homestay application, these initial fees are required. A 3.7% credit card fee will apply. Your application is considered incomplete if your payment information is not listed below. If you are an agent and would like to wire transfer your fees, or pay by another method, please email us at info@ihpshomestays.com.

Please choose:

International student- $385
US Student- $385
Intern- $475
High School Student- $475

Deposit: (Required for all applicants)

Housing Deposit- $100

Optional Service:

"Meet and Greet" Airport Pick up- $175.00

*Most airports. Students going from NY or EWR to Brookdale, and LAX to Santa Barbara please inquire about cost.

Late fee: (if applicable)

Late Fee- $75.00

Required if you are applying for homestay less than 2 weeks prior to check-in.

Credit Card Details:

Credit card number:

Expiration date:

mm/year

CVV code:

last 3 digits on the back of the card.

I understand that a 3.7% credit card processing fee applies.

Yes, I understand

Name on Credit Card

First

Last

Relationship to student:

Billing country:

Billing Address

Postal Code

I authorize IHPS Homestays to charge my placement fees to the above credit card. I understand that my homestay placement will not be confirmed until my application fees are received.

9. Housing Fees:

I would like to use this credit card for my housing fees. I authorize IHPS Homestays to place this card on file for all future housing payments.

Please note: IHPS will bill your first payment 1-2 days prior to check-in to homestay.

Please bill this card:

every 12 weeks
Other

1. Student Homestay Application

Emergency Contact Information

2. Agent Information: (leave blank if you are not an agent)

3. Housing Preferences

4. Medical Information:

5. Please tell us about yourself:

6. Optional Airport pick up service:

7. Student Housing Contract:

I understand, accept and agree to IHPS Homestays' Housing Agreement.

If you are under the age of 18 years old, your parent or guardian needs to sign here:

8. Homestay Application Fees:

Credit Card Details:

9. Housing Fees:

Thank you for choosing IHPS Homestays! Once we process your payment we will send you a receipt invoice and begin to work on your homestay placement.

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