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HOST FAMILY FOR INTERNATIONAL STUDENTS REGISTRATION FORM
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Step
1
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ABOUT YOU
Title
*
Select Title
Mr.
Mrs.
Ms.
Dr.
Prof.
Esq.
Hon.
Jr.
Msgr.
Rev.
Rt. Hon.
Sr.
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First Name
*
Surname
*
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Occupation
Email
*
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Phone
*
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Address
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
France
Ireland
Italy
Malta
Spain
United Kingdom
Do you live in
*
flat?
house?
other
Please specify the type of accomodation
Are you and the people living in your home fully vaccinated?
Yes
No
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Nearest Bus Route
Nearest Tube Station
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What is your ethnicity?
Please specify
African
Any other Asian background
Any other Black, Black British, or Caribbean background
Any other Mixed or multiple ethnic background
Any other White background
Arab
Bangladeshi
Caribbean
Chinese
Irish
Pakistani
Roma
White and Asian
White and Black African
White and Black Caribbean
White British
White Other
Other (please specify)
What is your religious background
Please specify
Buddhist
Christian
Hindu
Muslim
No Religion
Other
Please specify your ethnicity
Please specify your religious background
Please list your activities/hobbies
Archery
Baking
Blog writing
Boardgames
Camping
Chess
Cycling
Dancing
Fencing
Football
Gardening
Local meetups
Marathon running
Mountain climbing
Networking events
Painting
Photography
Playing a musical instrument
Reading
Sketching
Skiing
Swimming
Tennis
Theater
Volunteering at a charity center
Writing
Yoga
Other (Please specify)
Please list other activities/hobbies
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Do you have any pets?
*
Yes
No
Checkboxes
*
Cat
Dog
Other
Please specify other pets and/or tell us how many pets you have
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ABOUT YOUR CHILDREN
How many children (including those not living at home) ?
*
Child_1
Name (First Child)
Living at home?
Yes
No
Gender
Male
Female
Age
Occupation
Child_2
Name (Second Child)
Living at home?
Yes
No
Gender
Male
Female
Age
Occupation
Child_3
Name (Third Child)
Living at home?
Yes
No
Gender
Male
Female
Age
Occupation
Child_4
Name (Fourth Child)
Living at home?
Yes
No
Gender
Male
Female
Age
Occupation
Child_5
Name (Fifth Child)
Living at home?
Yes
No
Gender
Male
Female
Age
Occupation
As you have more than five children provide the rest of the details here.
*
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ABOUT YOUR HOSTING PREFERENCES
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What type of room(s) is available for the guest?
*
Single Bed
Twin Bed
Double Bed
Triple Bed
King Bed
Bedroom Furnishings
Desk
Chair
Table Lamp
Bedside Lamp
Cupboard
Chest of drawers
Wooden Floor
Carpeted Floor
Fridge
Freezer
Shelves
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Brief description of your room
*
Provide up to 5 pictures (optional)
Click or drag files to this area to upload.
You can upload up to 5 files.
What type of Meal Plan do you offer?
*
Self-Catering
Half-board
Full-board
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Special Dietary Habits
Flexitarian
Halal
Kosher
Pescatarian
Vegan
Vegetarian
Other
Please specify other dietary habit
Would you accept meat eaters?
*
Yes
No
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Have you hosted international students before?
*
Yes
No
Would you prefer male or female students?
*
Male
Female
No Preference
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Please state preferred length of hosting in weeks
*
2 weeks
2 months
More
Some of our students/guests may have unconventional working hours. Please choose preferred option
*
9am to 5pm
Mid-day
Evening (4pm to midnight)
No Preference
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Which category of guest do you accept?
*
Junior 12+
Young Adult 16+
Mature 18+
To host under 18 guests, you must be DBS Checked/Garda Vetted. We can assist you with the procedure.
*
I am DBS Checked/Garda Vetted
I would need assistance
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Do you feel that you can honestly present all family rules and responsibilities when our student first arrives?
*
Yes
No
Are You Prepared To Give Students a House Key?
*
Yes
No
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Do you or anyone on your household smoke?
*
Yes
No
Do you allow smoking?
*
Yes
No
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Do you feel that you and your family can welcome our student as a family member and not as a paying guest?
*
Yes
No
Have you or any member of your household been charged or convicted of a crime?
*
Yes
No
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YOUR REFERENCES
Referee 1
Referee 1 Full Name
*
Referee 1 Mobile Number
*
Referee 1 Email Address
*
Referer 2
Referee 2 Full Name
*
Referee 2 Mobile Number
*
Referee 2 Email Address
*
YOUR BANK DETAILS FOR THE RENT PAYMENT
Account Holder's Name
*
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Sort Code
Account Number
IBAN
BIC
DATA PROTECTION
MPA Coaching Homes will only use the information provided on this online form to try and offer you room bookings for students. Once we book a student with you we will email them your Registration Form and your contact details so that they can organise their arrival or for their parents and/or teachers to know where they are staying. If at any time you no longer wish to be registered with us, please email us at homes@mpacoaching.com and we will remove your dtails from our data base.
Yes I am happy for MPA Coaching Homes to use my information to receive room bookings
*
Yes
No
I confirm that I have read, understood and will abide by the Homestay Guidelines of MPA Coaching
*
Yes
No
I confirm that I have read and accepted the Terms & Conditions of MPA Coaching
*
Yes
No
Full Name
*
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