Application Form

Please complete this form and submit an advance copy by clicking on the SUBMIT button at the end of this form. Shortly after receiving your completed form, we will notify you on the availability of Homestays matching your requirements, and quote a specific Homestay Rate.

Your Total Homestay Cost will be:
an Application Processing Fee of $200.00 per person, plus your quoted monthly Homestay Rate.
Once you are notified of the Homestay availability and specific Homestay Rate, you will need to forward an Advance Payment to:

Pacific Northwest Homestay
c/o Aieleen Lanot
18846 Midvale Ave. N
Shoreline, WA 98133

Payment by wire transfer is available by request. We also accept payments in the form of a cashiers check in US dollars.

Shortly after we receive your Advance Payment, you will be sent the details on your Homestay Family and accommodations. Your Application Processing Fee will be refunded to you only if Pacific Northwest Homestay cannot find a Homestay per your requirements as stated on this form.

Short stays will be refunded 50% if cancelled 2 weeks before arrival, no refunds if cancelled a week before. Shortly after we receive your payment we will send you the details on your Homestay Family and accommodations.

Please note: Pick-up service at the airport is available, if required. A driver will meet you at the airport with a card carrying your name and take you to your Homestay family's home. Cost is $75.00, add to the processing fees and payments.

Please note : Airport Shuttle Pick-up Service is available, if required.
Please inquire about costs and details.

We apologize for inconvenience but we do not accept credit cards at this time.

First Name:
Last Name:
Address 1:
Address 2:
City:
State/Province/District:
Postal Code:
Country:
Telephone Number: (please include country and city codes)
Fax Number:
E-Mail:
Country of Nationality: (if different from above)
Name of Person(s) to Contact in case of Emergency:	This persons relationship to you (Mother, Father, Friend, etc)	Emergency Contact's Telephone Number: (please include country and city codes)



Name of Company, organization, or School you'll be attending:	Name of your Contact Person at the above location:	Contact Persons Telephone Number at the above location:

Please tell us how you first heard about Pacific Northwest Homestay, in the space below: Type in your comments here:
Your Gender: Male Female Age:
Your Expected date of *Arrival:*
If you're arriving by plane, Please advise flight arrival details to Sea-tac Airport (including Airline, Flight Number, and Arrival Time (AM or PM)), in the space below: Type in your comments here:
Your Expected date of *Departure:*
Your Expected length of stay:	month(s)
What type of accommodations would you prefer:	Economy Business Professional Standard Furnished Apartment Deluxe Bed & Breakfast
Are you a smoker? (Most Americans do not allow smoking in their homes, so you may be asked to smoke outside only.)	Yes No
Can you live with other smokers in the house?	Yes, other smokers are OK No, I prefer a non-smoking house
Do you have any allergies?
Are there any food you do not eat?
Would you prefer a family with children? (This question is asked solely to determine your opinion. It in no way implies that you will be expected to baby-sit.)	Yes, I prefer a family with children No, I prefer a family with no children No Preference
Can you live in a home with pets? (It may not be possible to place you in a pet free home because most Americans have pets.)	Yes No
Will you require a car parking space at the host Family residence?	Yes No
Please explain your purpose for coming to Greater Northwest Area, and tell us a little bit about yourself, including your interests, hobbies, etc., in the space below: Type in your comments here:

We cannot guarantee that all of your housing preferences will be met, but our housing coordinator will use the information to help arrange a compatible placement. Please read the waiver and release agreement documents to be fully aware of our policies and liabilities. If you are arriving before 8:30AM or after 4:30 PM or on a Saturday or Sunday there is an extra $100.00 fee for pickup.

If you have any problems submitting this form, please e-mail us instead, providing the same requested information.

Send mail to [email protected] with questions or comments about this web site.
Copyright � 2001 Pacific Northwest Homestay
Last modified: September 17, 2001

Please complete this form and submit an advance copy by clicking on the SUBMIT button at the end of this form. Shortly after receiving your completed form, we will notify you on the availability of Homestays matching your requirements, and quote a specific Homestay Rate.

Your Total Homestay Cost will be: an Application Processing Fee of $200.00 per person, plus your quoted monthly Homestay Rate. Once you are notified of the Homestay availability and specific Homestay Rate, you will need to forward an Advance Payment to:

Pacific Northwest Homestay c/o Aieleen Lanot 18846 Midvale Ave. N Shoreline, WA 98133

Payment by wire transfer is available by request. We also accept payments in the form of a cashiers check in US dollars.

Shortly after we receive your Advance Payment, you will be sent the details on your Homestay Family and accommodations. Your Application Processing Fee will be refunded to you only if Pacific Northwest Homestay cannot find a Homestay per your requirements as stated on this form.

Short stays will be refunded 50% if cancelled 2 weeks before arrival, no refunds if cancelled a week before. Shortly after we receive your payment we will send you the details on your Homestay Family and accommodations.

Please note: Pick-up service at the airport is available, if required. A driver will meet you at the airport with a card carrying your name and take you to your Homestay family's home. Cost is $75.00, add to the processing fees and payments.

Please note : Airport Shuttle Pick-up Service is available, if required. Please inquire about costs and details.

We apologize for inconvenience but we do not accept credit cards at this time.

First Name:

Last Name:

Address 1:

Address 2:

City:

State/Province/District:

Postal Code:

Country:

Telephone Number: (please include country and city codes)

Fax Number:

E-Mail:

Country of Nationality: (if different from above)

Name of Person(s) to Contact in case of Emergency:

This persons relationship to you (Mother, Father, Friend, etc)

Emergency Contact's Telephone Number: (please include country and city codes)

Name of Company, organization, or School you'll be attending:

Name of your Contact Person at the above location:

Contact Persons Telephone Number at the above location:

Please tell us how you first heard about Pacific Northwest Homestay, in the space below:

Type in your comments here:

Your Gender: Male Female Age: 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45-49 50-54 55-60 over 60

Your Expected date of Arrival:

January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2001 2002 2003

If you're arriving by plane, Please advise flight arrival details to Sea-tac Airport

(including Airline, Flight Number, and Arrival Time (AM or PM)), in the space below: Type in your comments here:

Your Expected date of Departure:

January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2001 2002 2003

Your Expected length of stay:

1/2 1 1 and 1/2 2 3 4 5 6 7 8 9 10 11 12 over 12month(s)

What type of accommodations would you prefer:

Economy Business Professional

Standard Furnished Apartment

Deluxe Bed & Breakfast

Are you a smoker?

(Most Americans do not allow smoking in their homes, so you may be asked to smoke outside only.)

Yes

No

Can you live with other smokers in the house?

Yes, other smokers are OK

No, I prefer a non-smoking house

Do you have any allergies?

Are there any food you do not eat?

Would you prefer a family with children?

(This question is asked solely to determine your opinion. It in no way implies that you will be expected to baby-sit.)

Yes, I prefer a family with children

No, I prefer a family with no children

No Preference

Can you live in a home with pets?

(It may not be possible to place you in a pet free home because most Americans have pets.)

Yes

No

Will you require a car parking space at the host Family residence?

Yes No

Please explain your purpose for coming to Greater Northwest Area, and tell us a little bit about yourself, including your interests, hobbies, etc., in the space below: Type in your comments here:

If you have any problems submitting this form, please e-mail us instead, providing the same requested information.

Send mail to [email protected] with questions or comments about this web site. Copyright � 2001 Pacific Northwest Homestay Last modified: September 17, 2001

Your Total Homestay Cost will be:
an Application Processing Fee of $200.00 per person, plus your quoted monthly Homestay Rate.
Once you are notified of the Homestay availability and specific Homestay Rate, you will need to forward an Advance Payment to:

Pacific Northwest Homestay
c/o Aieleen Lanot
18846 Midvale Ave. N
Shoreline, WA 98133

Please note : Airport Shuttle Pick-up Service is available, if required.
Please inquire about costs and details.

Telephone Number:
(please include country and city codes)

Country of Nationality:
(if different from above)

Your Gender: Male Female Age:

(including Airline, Flight Number, and Arrival Time (AM or PM)), in the space below:
Type in your comments here:

month(s)

Will you require a car parking space
at the host Family residence?

Please explain your purpose for coming to Greater Northwest Area, and tell us a little bit about yourself, including your interests, hobbies, etc., in the space below:
Type in your comments here:

Send mail to [email protected] with questions or comments about this web site.
Copyright � 2001 Pacific Northwest Homestay
Last modified: September 17, 2001