Participant Information:

Contact Information:

Emergency Contacts in origin country:

Medical Information:

Do you have any allergies for the categories below? Please explain:

If yes,

Education and Training:

University / High School

Internship Preferences:

Personal Declaration:

References Academic/Professional:

Home-Stay Preferences:

This information will be used to find a good guest - host match. However, it is not a guarantee that all of your preferences will be met

Be honest ! If you are a  smoker, you will be required to do so outside as most host families are non-smoking. Should you cause smoking damage, you may be responsible to pay.