Fillable Homestay Application (Southern Utah University)

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Homestay Application (Southern Utah University)

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HomeStay Program – Student Application
351 West University Blvd. Cedar City, UT 84720
435.592.4770 kailibrown@suu.edu
Thank you for choosing the SUU Homestay Program as your housing option. Please fill-out every field below with
complete and accurate information. If a question does not apply to you please enter the word “None” into the
answer field. In order for the application to be officially submitted, every field mustbe filled in. If you have more
details than space provides, please attach information on an additional page.
First Name:
Last (Family Name):
Other Names Used:
Home Country:
SUU Student ID (T-number):
Personal Email Address:
Gender (circle):
Male Female
Date of Birth (mm/dd/yyyy):
Please indicate which SUU term(s) you would like to reserve a homestay:
__ Early College __ Spring 1
__ Spring 2 __ Summer 1
__ Summer 2 __ Fall 1
__ Fall 2
Have you attended another college or university before SUU? Yes No
If so, please include the name of the institution and how long you attended.
Starting and ending dates (mm/yy):
/ to /
How many years of English Language courses have you taken?
Starting and ending dates (mm/yy):
/ to /
Are you willing to walk to campus? Yes No
Do you expect transportation to campus? Yes No
Do you practice any religion or attend religious services regularly? Yes No
If so, please indicate the religion and when you like to attend services:
Do you smoke? Yes No
Do you have any pet allergies or fears? Yes No
If so, please indicate what type of animal(s):
Do you have any dietary needs, allergies or cultural restrictions?
Do you have any special medical or physical needs? If so, please describe them below:
Please answer the following questions as fully as possible. Again, if you have more details than space provides,
please attach information on an additional page.
What are your hobbies or interests?
What is your favorite meal?
What do you want to learn while attending SUU?
What do you want to see while you live in Cedar City, Utah?
What would you like to do while you live in the United States?
Why do you want to have a homestay experience?
What would you like your hosts to know about you?
I agree to the statement above: __ I Agree
Additional Attachments Included: Yes No
If yes, how many attached pages?
Please carefully read the following statement below. All homestay students must agree to and abide by the following
guidelines. Any student who does not agree to the guidelines will not be placed in a homestay.
•
Students must fill out and send this online student homestay application to SUU to allow us to make the best placement.
Students must be comfortable living with any family type. Many of our hosts have small children, many have pets, and
others may be single parent households.
•
We cannot make placements based on family type and all families are considered equally when assigning students.
•
You and any visitors to the home should treat the host family animals with kindness, as the host family requests.
•
Minimum homestay duration is 8 weeks, except by special arrangements made with ESL Homestay Coordinator prior to
placement.
Form Submission Instructions for Student
Applications of the SUU English as a Second
Language Homestay Program
After you fill out the previous two pages:
1. Please PRINT and SAVE your application as a PDF file.
2. Attach the PDF in an email and send it to: kailibrown@suu.edu
3. If you are not yet in the U.S., include your arrival date, time, airline information and the flight number
in your email.
4. If you need a shuttle service from the airport, please include detailed information. We provide shuttle
service from St. George and Cedar City airports.
5. You can request shuttle service online at: https://www.suu.edu/iss/shuttle.html
6. Include a contact mobile phone number or email for us to reach you while you are traveling. This is to
help you in case of delays en-route.
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Homestay Application (Southern Utah University)

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Completed 25 July 2020

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