Gaston Christian School

Host Father's Name * First Last
Host Mother's Name * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell or Home Number * ### - ### - ####
Best number to reach you.
Host Father's Age *
Host Father's Occupation *
Host Father's Business Number * ### - ### - ####
Host Mother's Age *
Host Mother's Occupation *
Host Mother's Business Number * ### - ### - ####
Do you have a home computer? *
Yes No
Home Email address *
Family Information:
List other members of the household First Last
List other members of the household First Last
List other members of the household First Last
List other members of the household First Last
List pets
Does anyone in your home smoke? *
No Father Mother Child Other
Student must have his/her own room with a desk? Is there a chance that this is a difficulty? *
Has anyone in your immediate family ever been convicted of any offense other than a minor traffic violation? If yes, please explain. *
No Yes, please explain
Family's Religious Preference *
Do you attend church regularly? *
Yes No Other
Will you commit to involving the student in the Youth Group associated with your church or another church? This will involve providing transportation to meetings and events. *
Yes No
Emergency Contact Name * First Last
Name of a relative or friend (not living in the home) to contact in case of emergency:
Emergency Contact Phone Number ### - ### - ####
Phone number of a relative or friend (not living in the home) to contact in case of emergency:
Emergency Contact Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Does anyone in your family play a musical instrument? If so, describe. *
What are the interests and activities enjoyed by your family?
What are the household duties of your children? *
What household duties would be expected of your student? *
What is your general opinion of Gaston Christian School? *
Method of transportation to school and distance. *
Describe your neighborhood activities available for students. *
How did you hear about Gaston Christian School International Student Host Program? (newspaper, friend, etc.) *
Briefly describe why you would like for your family to be involved in the ministry of the International Student Homestay Program? *
If you are selected as a host family, do you feel that your family could welcome the student as a family member and not as a guest? *
Yes No
Would extended family members welcome the student as a family member as well? *
Yes No
I/We agree to supply 1 letter of reference from our Pastor and 2 letters of reference from business or personal sources. After references and application are checked, if our family is chosen to become a Host family, I/we agree to uphold all GCS rules and regulations and will abide by the decisions made by GCS officials. *
Yes No
Attach a File
Attach a File
Do you know of a family who may be interested in hosting for Gaston Christian School? If yes, please give their name and phone number or email address.
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Gaston Christian School

Family Information: