Online Host Application Step 1 of 8 12% Personal DetailsTitleFirst NameLast NameMarital StatusGenderMaleFemaleDate of Birth NationalityOccupationFull Address (inc. postcode)Daytime Telephone NumberEvening Telephone NumberMobile Telephone NumberEmail Address Host DetailsPlease provide all members of your householdPlease provide their name, age, relationship to yourself and also their occupation. Do you have any pets?YesNoWhat type of pets and how many?Is at-least one adult in your household a native English speaker?YesIf no, please specify native language in 'other'. Is English the main medium of communication in the home?YesNoDo you have any preference of the gender of the student?No preferenceMaleFemaleWould you be prepared to provide accommodation to students of the other gender if we were unable to match you with a student of the gender of your preference?YesNoHave you provided homestay accommodation for visiting foreign students before?YesNoPlease indicate which institution(s) you have worked with before?Have you provided lodgings for students of any nationality studying in Manchester before?YesNoPlease indicate which institution(s) you have worked with before?Please describe below your hobbies and activities you undertake: Student Room and FacilitiesWhat is the size of the room bedroom you have available to accommodate to the student?Where is the bedroom situated?Ground FloorFirst FloorSecond FloorWould you be able to accommodate a student of limited mobility?YesNoWhat is the type of flooring in the bedroom?How is the student bedroom heated?How is the student bedroom lit?Is there a desk or table and chair in the bedroom that the student can use for the purpose of study?YesNoPlease specify if there is a desk/table and chair elsewhere in the home which the student can use to study undisturbed?Will the student be sharing a bathroom, or will they have a private bathroom?SharingPrivate BathroomDoes this bathroom have a shower or a bath?ShowerBathIt has bothPlease specify if there is a place in your home where the student can securely store valuables such as passport and flight tickets.Do you have an internet access at home?YesNoWould you allow the student to use your computer?YesNoWould you allow the student to connect their own computer to the internet?YesNoAre there parking facilities at your home? (Certain students will be bringing cars to the UK with them) No Parking Available Unlimited Off-road Parking Unlimited On-road Parking Permit Parking (I can supply a permit) Catering for the studentPlease refer to Point 9 in the ‘Minimum Requirements and Code of Practice for Homestay Hosts’ regarding catering for the student.Are you or any other members of your family vegetarian or vegan?YesNoWould you expect the student to follow a vegetarian or vegan diet?YesNoDo you or any of your family members have any other dietary restrictions?YesNoPlease specify what your dietary restrictions are:Would you expect the student to follow this diet?YesNoWould you be prepared to cater for the following diets? Vegetarian/Vegan Meat eater Muslim - Halal meat (No pork products) Nut free Gluten free Diabetic Smoking/AlcoholAre you or any of your family smokers?YesNoWould you allow the student to smoke in the home?YesNoWhere in the home?Would you accommodate a student who would smoke outside the home?YesNoDo you permit alcohol in your home?YesNoDo you have working smoke alarms fitted in your home which are regularly tested?YesNoPlease specify the location of these alarms:Do you have any gas appliances in the home and, if so, can you provide evidence that they are in good working order? (E.g. a copy of your gas service record or safety check that will be valid for the duration of the homestay period).YesNoNot applicable (i.e. no gas supply)A copy of your gas service record or safety checkDoes your household insurance policy cover you for accidental damage or injury to property and persons whilst guests are resident in your home?YesNo LocationWhat amenities are there within a 15-minute walking distance of your home? Pub(s) Newsagent(s) Shop(s) Restaurant(s) Post Office Bank(s) Cinema Library What is the journey time by bus, train or tram from your home to the centre of Manchester?Between 0-10 minutesBetween 10-20 minutesBetween 20-30 minutesBetween 30-40 minutesPlease specify the frequency at peak times.About every 10 minutesAbout every 20 minutesAbout every 30 minutesAbout every 40 minutes Students aged under 18Would you consider hosting a student aged under 18?First ChoiceSecond ChoiceThird ChoiceFor hosting students aged under 18 years of age, we require the consent form to be signed by all of your family member in your house who are 18 years old and over. Please ask all of your family member in your house who are 18 years old and over to sign and date the “Declaration of suitability to accommodate students aged under 18”.If you have obtained a copy of DBS check, please provide a copy to us. The declaration is not required. Download Declaration Form Please download this form and get the members of your family to sign it and send it back to us at firstname.lastname@example.org or you can mail it to: Host Applications, Manchester Central School of English 2nd Floor, Royal Buildings 2 Mosley Street Manchester M2 3AN, United Kingdom Final StepPlease indicate here any additional comments you might have.Thank you for your cooperation in completing this questionnaire. Please print your name below to show that you have read and understood our requirements for homestay hosts. By submitting I have read and understood the “Minimum Requirements and Code of Practice for Homestay Hosts”. Should I host a student in arrangement with the Manchester Central School of English, I agree to abide by the conditions therein. I agree to inform the school immediately if at any point either before or during the homestay period, I become unable to meet one or more of those conditions. I understand that school staff may wish to visit my home by prior arrangement before and/or during the homestay period. By submitting I declare that the information contained in this application is correct to the best of my knowledge and understand that any false statement may result in my application being withdrawn or my appointment being terminated. Print NameFull Legal Name This iframe contains the logic required to handle Ajax powered Gravity Forms.