HOMESTAY APPLICATION PACKET For International Student

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1 Tel ~ Fax ~ HOMESTAY APPLICATION PACKET For International Student Quarter Priority Deadline After Deadline Fall (September 2016) By July 29 th, 2016 Application accepted for space available basis. Winter (January 2017) By November 18 th, 2016 Spring (April 2017) By February 10 th, 2017 Summer (July 2017) By May 12 th, 2017 *Students aged 16 & 17 must submit the completed homestay application packet by the deadline above due to limited availability. Please plan your visa appointment accordingly. 1. Read all the information in this packet. 2. Complete the homestay application form. 3. Complete the Rules and Agreement Form for Minors with signatures of your parents or a legal guardian if you are under 18 years of age. 4. Prepare a self-introduction letter to your homestay host and a recent photo, and submit with the homestay application. 5. Enclose a check or money order for $150 payable to Olympic College for the homestay application fee, or fill in the Visa/Master Credit Card information page of the application. (The homestay application fee is non-refundable.) 6. Send the documents to: Mailing address: Office of International Education Olympic College 1600 Chester Ave. Bremerton, WA 98337, U.S.A. Fax: If you choose to fax or the documents, please scan signed documents. Digital signatures or typed names will not be accepted as signatures. Revised 4/8/2016

2 STUDENT GUIDELINES FOR LIVING IN A HOMESTAY Olympic College tries to be fair to both the homestay host and the student. Both parties must read and agree to certain guidelines. Please read this information to be sure you are willing and able to participate fully in the homestay option. Homestay commitment and responsibilities When a host has been selected for you, the college will notify you of their contact details. The first ten days at the homestay are an adjustment period for both host and student. The college will help the student make a change the homestay arrangement only under extreme circumstances depending on the host family availability. After the adjustment period, a student will stay in the homestay option at least one quarter/session or 12 weeks/6 or 8 weeks for summer. Additional homestay placement fee of $150 will be charged for each change. A student must give the host a 20- day notice before moving out. If the student does not give a 20- day notice, the deposit and any prepaid rent may be lost. Note: Although all attempts will be made to match host/student request, the college is not responsible for the lifestyle, behavior, philosophy or religious affiliation of the host. Family life and homes Host families are from many different ethnic groups and live in many different types of homes. While the college tries to make a good match for the student, the college cannot promise to fill all requests. All homestay students will be provided a private bedroom, bed, dresser, desk, chair, lamp, closet, towels, bedding and house key. Rules Students must pay for their own long distance phone calls or use their own cell phones. Smoking is not allowed in most homes. Students may expect to be asked to help with small household chores, such as helping with dishes, cleaning up after themselves, or vacuuming. Students are expected to clean their own room. Usually, students may not use the homestay host s computer. Some hosts may allow students to set up and pay for a separate phone line or Internet. Students may also use the Internet services at the college. Student responsibilities Students must notify the homestay coordinator if there are homestay problems or concerns, as we may be of assistance. If a student moves out of their homestay: a. The host s house key must be returned; Student: Page 2

3 b. The host must be provided with the new address to forward mail; c. The room should be left as clean as upon arrival; d. Any damages a student causes at their homestay must be paid for by the student. Personal property Students are encouraged to establish a personal bank account upon arrival. College staff will help students with setting up an account. The student s personal property is not the responsibility of the college or the host family. Any losses, including personal property, lost or stolen money that is not covered by an insurance policy, is the responsibility of the student. Code of conduct All students enrolled at the college, including those in homestay, must agree to the Student Code of Conduct (see the Student Handbook.) Students are expected to: Maintain high standards of honesty and trustworthiness; Respect the rights, privileges and property of others; Agree to follow the policy and procedures of the college. Vacation policy Students who wish to go out of town while living in homestay must prearrange the absence with the host family. If students plan to be away for 15 or more nights, the monthly stipend is reduced 50%, but only for the nights that the student is away. For absences of less than 15 nights, there is no reduction in the monthly payment. Student: Page 3

4 HOMESTAY OPTIONS AND FEES Office of International Education 1. Traditional homestay - $625 per month The monthly fee is due to the host each month, based on the date the student moved in. Private bedroom with bed, desk, chair, light, dresser, closet, towels, bedding, and house key provided. The host provides and prepares five evening meals each week. Students make their own breakfast, lunch and weekend dinners with food provided by the host. Not included: Personal expenses, transportation, bus fare, long distance phone calls. 2. Room and kitchen access - $450 per month The monthly fee is due to the host each month, based on the date the student moved in. Private room with bed, desk, chair, light, dresser, closet, towels, bedding, and house key provided. The student may purchase and prepare their own food using the host s kitchen. Not included: Food, personal expenses, transportation, bus fare, long distance phone calls. TOTAL COSTS Application fee $150 (submitted with the homestay application; non-refundable unless a homestay cannot be found) Cleaning fee $50 (Student pays directly to the host upon moving in) Security/damage deposit $100(Student pays directly to the host upon moving in)* Monthly fee $625 or $450 per month (Student pays directly to the host each month, based on the move-in date.) * The security/damage deposit will be returned to the student up to 30 days after moving out if there are no unpaid bills or damages and the student gave the host a 20- day notice before leaving. Airport Pick up fee (if you chose this option) $100 for scheduled arrival dates. $150 for non-scheduled dates if arranged in advance. Student: Page 4

5 HOMESTAY APPLICATION (Complete all information) Mr. Ms. Mrs. First name Last name Date of birth Nationality Current address (if applicable) Street address City, state, postal code Phone Fax Permanent address (if different than above) Street address City, country, postal code Phone Fax Agency involved with placement (if applicable) Agent name and agency Street address City, state/country, postal code Phone Fax Emergency contact Name Relationship Street address City, state/country, postal code Phone Fax Student: Page 5

6 What quarter do you plan to start? Summer, Fall, Winter, Spring, Year Homestay preference: Traditional, Room and kitchen access only Either How long do you plan to live with a homestay host? 1 quarter (3 months), 2 quarters (6 months), 3 quarters (9 months) or more Current English conversation level: Intermediate, Advanced What is your native language? Other languages you speak (other than your native language and English): Current or desired occupation: What is your field of study or major? Would you be comfortable with: A family that owns a dog? Yes, No, No preference A family that owns a cat? Yes, No, No preference Would you prefer: Small children in your host family (under six years old) Yes, No, No preference Older children in your host family (between 6 and 14 years old) Yes, No, No preference Do you want to spend a lot of time with your host? Yes, No, No preference Do you play a musical instrument? Yes, No If yes, what instrument(s)? Do you own a car? Yes, No Do you plan to get a car? Yes, No Do you smoke? Yes, No Do you drink alcohol? Yes, No Father s occupation (if applicable) Student: Page 6

7 Mother s occupation (if applicable) Do you have brothers or sisters? If yes, what are their names and ages? Do you have any of the following? YES NO Describe if you checked Yes. Health problems Special physical requirements Food allergies Animal allergies Taking medication Special Diet (Food) Please list activities, hobbies and/or sports you like to do: Please note that all requests may not be met, although we will try to place you with a host that will match most of your needs. I have read and understand the information provided in the homestay application. The information I provided on the application is truthful and accurate. I understand that by signing the application I agree to the rules and regulations listed and will participate in the homestay option to the best of my ability. Also, I give Olympic College permission to share information provided on this application with my prospective homestay host. Signature Date Student: Page 7

8 Dear Host Family, A Letter to Host Family Sincerely, Name: Student: Page 8

9 Rules, Agreement and Release for Students Under Age 18 (part1) (Students 18 years of age or older are not required to complete this form.) The undersigned student of Olympic College and the student s natural parent(s) and/or legal guardian agree to the following rules: 1. Students must obey local, state and federal law. Drinking alcohol is prohibited until age 21. Smoking is prohibited until age 18. Illegal drugs are prohibited for persons of any age and students should not be associated with anyone involved with illegal drugs in any way. 2. Students under the age of 18 must get approval from the host family for all activities. At all times, the host family must know where the student is, with whom, and when the student will return. 3. Students must obey the house rules and respect the property of the host family. 4. Students and natural parents must respect decisions made by Olympic College officials. In addition, the undersigned student and the student s natural parent(s) and/or legal guardian(s) acknowledge certain facts and release the college and the host family as follows: Personal property. The student s personal property is not the responsibility of the college or the host family. Any lost or stolen personal property of the student, including lost or stolen money, which is not covered by an insurance policy, is the responsibility of the student and the student s natural parent(s) and/or legal guardian(s). Students must establish a bank account separate from that of their host family. Insurance. Any medical expenses or lost/stolen property or damage not covered by applicable insurance of the student is the responsibility of the natural parent(s) and or legal guardian(s) of the student. Medical insurance. Neither the college nor the host family is responsible for any medical expenses incurred by the student. The student must obtain medical insurance coverage for the term of his/her stay through OC authorized vender. Note: Dental and vision care is not included. Property and liability insurance. Neither the college nor the host family is responsible for any property damaged or destroyed by the student or for any liability that results from the student s activities while enrolled at OC. The natural parent(s) and/or legal guardian(s) of the student is (are) responsible for any damage or destruction of property or any injury to persons inflicted or caused by the student while living with the host family and/or enrolled at the college. Student signature Date Student: Page 9

10 Rules, Agreement and Release for Students Under Age 18 (part 2) In addition to the foregoing, the natural parent(s) and/or legal guardian(s) agree to the following: PERMISSION FOR MEDICAL CARE AND RELEASE: I (we), as the applicant s natural parent(s) and/or legal guardian(s), agree to authorize Olympic College or the host family to act for us in any emergency, accident or illness during the period of time the student is admitted and enrolled at the college. This covers the period from the time the student boards transportation scheduled by Olympic College in the United States until the student leaves the return scheduled transportation by the college. PERMISSION FOR HOST FAMILY TO AUTHORIZE STUDENT ACTIVITY AND SIGN MEDICAL RELEASE DOCUMENTATION: I (we), as the applicant s natural parent(s) and/or legal guardian(s), agree to authorize the host family to sign student activity permission slips and corresponding medical release forms. I (we) further agree to fully indemnify and hold harmless both Olympic College and our child s host family from any and all liabilities, including liabilities to third parties, which may arise from the student s participation in the activity. Natural father/legal guardian: Name Address (street address, city, state, postal code, country) Phone Signature Date Natural father/legal guardian Natural mother/legal guardian: Name Address (street address, city, state, postal code, country) Phone Signature Date Natural mother/legal guardian Student: Page 10

11 Payment Authorization Form I, hereby authorize Olympic College to (Card holder s Name) charge my credit card for fee(s) below for SID:. (Student s Name & Student ID number if available) Items International Student Application fee $ 50 CHECK Code IP Amount (US$) Homestay Application fee $150 IH International Student Airport Pickup fee $100 for scheduled dates I2 I2 Total Charge Name on the card: Card Number: Expiration Date: Three digit security code: (Last 3 digits number on back of the card) (Signature) (Date) Student: Page 11

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