St. Louis Language Immersion Schools

Host Application

Thank you for your interest in becoming a Volunteer Intern Teacher Host

First name

Last name

Street Address

City

State

Zipcode

Best contact time

Home phone

Daytime phone

Mobile phone

Evening phone

Reference name

Reference relationship

Reference email

Reference phone

How many?

People in your household

Over 18 yrs

Minors

Anything else you'd like us to know? Family hobbies, other langauges spoken...

Do you have pets?

Please list all pets (kind, age, indoor/outdoor)?

Applying to host an intern from which school

I am interested in hosting

If other, please describe

Gender Preference

Smoking Preference

Can you provide a private room (required)

Can you provide breakfast and dinner on school days and all meals on weekends?

Have you hosted before

When and for which organizations

Please list any restrictions or specific requests