(888) 472-1918 24/7 Emergency and Intermediary Services info@wwgsa.com
Select the housing that best matches your interests (place a check next to all that apply):*
Name#1:*
Name#2:*
Address:*
Phone#1:*
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Phone#2:
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E-mail:*
Occupation:*
List High Schools or Universities near you*
Children/House Guests (under age 18):
Children/House Guests (under age 18):(1)
How did you hear about WWGSA?*
Please provide a brief description about you, your family, your hobbies and how you think your home will be a lasting impact in the life of a student:*
Age:
Age:(1)
Gender:
Gender:(1)
Do you have Pets in your home? *
What Kind?
Do you have any special dietary restrictions or allergies in the home? If yes, please explain and will the student be required to follow?
Are there special attributes to the location of your home? (i.e. parks, close to town, special attractions nearby?)
How many bedrooms*
How many bathrooms*
How many floors*
Separate game room/family room?
Will student be required to carry out special chores or responsibilities (i.e. do you live on a farm or other special environment. Please explain if Yes)*
Are you located within 10 miles of the local school? *
Bus service available? *
Are you able to transport the student to/from school and/or after school activities? *
Have you hosted a student in the past? *
If yes when?
Will the student share a room?*
If yes, boy or girl?
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