International Student Homestay Application
University of Missouri-Kansas City
Applied Language Institute
The Applied Language Institute requires a non-refundable $50 fee before processing your homestay application.
A credit card processing form is included at the end of the application for your convenience.
Important Guidelines:


Homestay cost (breakfast and dinner provided) - $800 per month
Homestay cost (no meals provided) - $500 per month

Students need to pay a minimum of one month’s rent to their host. If you decide to move before the
first month ends, you will still pay rent for the entire month.

Unless there is a serious reason for moving, we ask that you stay with the same host for at least 30
days. The first month is a trial period, to see if the host is a good match for you.
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Moves are only made for valid reasons. Each case will be examined individually.
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There is a $50 moving fee.

Basic (beginner) ALI students are not permitted to live in a homestay. Student needs to test into level
1 or higher to live in a homestay.
Please complete the questionnaire below so we can find the appropriate host for you!
Name: _____________________________________
Male/Female: ___
_ Age: ___
_ Date of Birth: _____________________________
Mo/ Day/ Year
Address: _____________________________________Home Phone #: ________________
City/State/_________________________________________________________________
Country/Postal Code: _______________________________________________________
E-Mail Address: _________________________
Fax Number: _______________________________
Are you currently attending school? _____ Name of School: _______________________________
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Area of Study: _______________________________
First Language ____________________________Country
_
Do you need a homestay for: One Month ____ Two Months ___ Four Months ____ Longer ___
Are you currently employed? _____ What type of work? ______________________________
What is your arrival date _________________Time_________ Flight #: ____________________
What date will you leave Kansas City? __________
Do you plan to have a car in Kansas City ______
Do you smoke tobacco? _____; If so, are you willing to go outside to smoke? ________________
Please describe any medical/dietary restrictions or allergies that you have: __________________
_________________________________________________________________________________
Please tell us a little about yourself. Describe your family, the things you like to do (sports, entertainment,
etc.), what you like and dislike, your favorite foods . . . . At the end of your statement, write one sentence
that best describes your personality:
_______________________________________________________________________________
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Please answer the following questions “YES” or “NO:”
Will you ride a bus to school? _________
Do you want your host to provide meals? ________________
Do you want to buy and prepare your own food?_________
**If you prefer your usual eating habits, please consider buying and cooking your own meals.
Do you prefer a home with Pets?______ -- or-- without Pets?_______ Don’t care______
Are you willing to live with pets in the house?_______ (Most of our hosts have pets.)
Do you prefer a home with Children?_____--or without children?____ Don’t care________
If you smoke, are you willing to smoke outside? ____
For homes where meals are provided: Your host will provide breakfast and dinner. Lunch is not provided.
You will join the family for their normal evening (dinner) meal.
Breakfast is provided, but you may need to prepare your own. A common breakfast in the U.S. consists of:
cereal, assorted breads, fruit, eggs, milk, juice, or coffee.
Homestay cost (breakfast and dinner provided) - $800 per month
Homestay cost (no meals provided) - $500 per month
Please remember your eating habits may be different from the eating habits of your host.
The information that I have given is true and correct to the best of my knowledge.
________________________
Signature
________________
Date
Your answers will help us find the right home for you. However, we may not be able to find a homestay that
meets your requests. In that case, we can help you find accommodation either on or off UMKC’s campus.
Telephone: 816/235-2594
Fax:
Fran Golden: goldenf@umkc.edu
816/235-5437
E-Mail: umkc-ali@umkc.edu
Please visit our web site at:
www.umkc.edu/ali
You might also be interested in learning more about Kansas City; for example, what you can do for
entertainment and what the weather is like. Please visit Kansas City at:
www.kansascity.com
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Credit Card Authorization
Please return paperwork to:
Applied Language Institute
5301 Rockhill Road
Kansas City, MO 64133
Attn: Elisa Day
Date:
Signature:
Name:
For:
Amount:
MasterCard
Visa
Discover
(Circle One)
American Express
Card Number:
Expiration Date:
Apply to Account Code: K1764 495000
Thank you for your interest in our program.