San Diego Coastal Homestays- California Student Exchange, Homestay, and Surfing Programs

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College Student Application

Please fill out the form below as completely as possible to ensure the best match with your host family. Starred (*) fields are required.

Basic Info

Last Name *Enter student's last name
First Name *Enter student's first name
Address *
AddressAddress Line 2CityState / Province / RegionPostal / Zip CodeCountry
Email *Best e-mail address for regular contact
Home Phone *
Cell Phone or other secondary number
OK to text?
May we text your cell phone? (Only for last minute updates.)YesNo
Age *
Sex *
Birthdate *mm/dd/yyyy
School *What school do you plan to attend?
Arrival *What is your projected arrival date? (mm/dd/yyyy)
Departure *What is your projected departure date? (mm/dd/yyyy)

Family Information

Father's Name & Occupation
Mother's Name & Occupation
Sibling's Names & Ages

Personal Information

Placed Solo? *
Would you prefer to be placed alone or with a friend?YesNo
Friend What is your friend's name?
Native Language *What is your native language?
Other languages? Do you speak any other languages?
Studied English *How long have you studied English?
English Ability *
What is your English speaking ability?GoodFairPoor
Allergies *
Do you have any allergies?YesNo
Allergic to What are you allergic to?
Medication *List any medications you are taking (Enter none if none)
Smoking Home? *
Do you mind being placed in a home with a smoker?YesNo
Do you smoke? *
YesNo
Do you like pets? *
YesNo
What type of pets? What type of pets do you have, if any?
Children *
Do you like young children?YesNo
Personality *
How would you describe yourself?TimidOutgoingSociableAdaptable
Quiet Home *
What type of home would you prefer?QuietActiveDon't Care
Church *
Would you prefer to be placed with a family that attends church?YesNoDon't Care
What denomination?
Hobbies *What are your hobbies and interests?
Subject *What is your favorite subject at school?
Food *What is your favorite food?
Talent *Do you have any special talents? (acting, music, etc.)
Letter *
Please write a letter to your future host family.
Photo *Please upload a recent photo of yourself (head shot in .jpg or .gif)

Verification

Please enter any two digits with no spaces (Example: 12) *
This box is for spam protection - please leave it blank

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SDCH Home
Host Family Information
Available Students
Group Itineraries
Application Forms
Photos and Videos
Outbound Programs
Testimonials
About Us
Contact Us
SDCH News
Privacy Policy
Our Team