HOMESTAY PROFILE
Date:
FAMILY NAME(S):
Street Address:
Development:
City, State, Zip:
Home phone number:
Primary e-mail address:
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(for student and homestay contact)
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What is the distance from your house to the ELI building located at 108 East Main Street, Newark, DE?
(Please use Google Maps to figure the mileage)
Miles:
Minutes by car:
Minutes walking:
Homestay owners must provide transportation if the homestay is located more than one mile from 108 East
Main Street or the homestay is not on the UD shuttle bus route.
Homestay owners are asked to not send their students to class on the public bus system. If your home is the
Newark area, please show the students the UD Bus Route/Schedule and the Unicity Bus Route/Schedule.
ABOUT YOU AND YOUR HOME
Homestay Owner #1
Name:
Additional phone numbers:
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(Please note - mobile, work, other)
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Year of birth:
Occupation and location of workplace:
Homestay Owner #2
Name:
Additional phone numbers:
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(Please note - mobile, work, other)
Year of birth:
Occupation and location of workplace:
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Relationship Status of Homestay Owner(s): Click here to enter text.
Other family members or friends living in your home (no need to list ELI students):
(For each person, please list the name, year of birth, occupation, and relationship to you.)
Name
Year of Birth
Occupation
Relationship to Homestay Owners
☐ Yes
Do you have any special dietary practices or restrictions?
If yes please explain: Click here to enter text.
☐ No
Do you have any pets?
☐ Yes
☐ No
If yes, what kind and how many? Click here to enter text.
Are there any smokers in your home?
☐ Yes
☐ No
If you practice a religion, what is your religious affiliation?
(Examples: Buddhism, Christianity, Hinduism, Islam, Judaism, non-religious, other)
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What languages are spoken in the home? Click here to enter text.
To which countries have you travelled?
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What are the interests and hobbies of the household members?
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What kind of leisure activity can you offer to the student(s)?
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STUDENT PREFERENCE
Gender of student (Male, female, no preference): ☐ Male
Will you allow a student to smoke outside your home?
☐ Female
☐ Yes
☐ No preference
☐ No
Would you prefer a student who is independent or someone who enjoys spending time in activities with
you and your family? Click here to enter text.
How many students are you able to house in private bedrooms? Click here to enter text.
HOMESTAY ACCOMODATION
What kind of accommodations are you willing to provide? Please X all which apply:
☐ Traditional: Includes 7 breakfasts, 7 dinners, & 2 weekend lunches each week
☐ Standard: Includes 7 breakfasts & 5 dinners each week; kitchen access for cooking
☐ Dinner only: Includes 7 dinners each week, kitchen access for cooking
☐ Breakfast only: Includes 7 breakfasts each week; kitchen access for cooking
☐ No meals: No meals provided; kitchen access for cooking
All meal plans include a weekly trip to the grocery store and kitchen food storage space. All students must
buy their own lunch on campus on school days and buy their own snacks and sodas.
ABOUT YOUR HOUSE
Type of house:
(Ex: Colonial, Ranch, Cape Cod, Townhouse, Apt, etc)
Number of levels:
Number of bedrooms:
Number of bathrooms:
Other details:
(Examples: big yard, basketball hoop, pool on property, in
neighborhood, on farm, etc.)
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Please place an X next to all which apply to your home.
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High Speed Internet
Wireless Internet
Fire extinguisher
Smoke detectors
Air Conditioning
Washer and dryer
Television available for student use
Private bathroom available to each student
Access to kitchen
Rice Cooker
Piano
Other: Click here to enter text.