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2024 Haddonfield Japan Exchange Host Family Application
This form should be completed by the Haddonfield student (grades 9-12) with the knowledge and permission of their parent(s) for the answers to each question. After filling in this form, be sure to have both the student AND the parent email
HJE08033@gmail.com
and state that you both agree to participate. This will serve as a substitute for a signature.
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* Indicates required question
Student Full
Name
*
Your answer
Student Grade Level
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9th
10th
11th
12th
Other:
Student's email address
*
Your answer
Student's Instagram (will likely be used to communicate with the Japanese student)
*
Your answer
Student phone number
*
Your answer
Home address
*
Your answer
Parent's email address
*
Your answer
Parent phone number (to be used in emergencies)
*
Your answer
Why do you want to participate in the Haddonfield Japan Exchange?
*
Your answer
What qualities or experience do you have that will make you a responsible, respectful, and active participant?
*
Your answer
Please list all family members (names, relationship to the Haddonfield student, and grade level, if applicable) in the home where the Japanese student will stay.
Example:
1. Jane Doe, Mother
2. Emily Doe, Sister, 4th grade
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Your answer
Describe your hobbies, interests, and extracurricular activities.
*
Your answer
Describe your family members' interests and occupations. Japanese students will use this information to bring personalized gifts.
*
Your answer
If you traveled to Japan in 2023, would you like to host the exchange partner that you had? If yes, please write your partner's full name. If this doesn't apply to you, write "not applicable."
*
Your answer
Will your Japanese student have to share a bedroom? If so, with whom? Please describe the living arrangements.
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Your answer
Is smoking permitted in your house?
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Yes
No
Other:
Can you host a vegetarian?
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Yes
No
Other:
Can you host any other dietary needs, like gluten-free, nut-free, or other food allergies?
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Yes
No
Other:
List all pets that you have
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Your answer
Do you have any other family rules, observances, or values that you would like a host student to know in advance?
*
Your answer
Do you have any concerns or anything else we should know about your ability to host?
Your answer
I have read and agree to the
Hosting Guidelines
*
Yes
No
Other:
After the student fills in this form, be sure to have both the student AND the parent email
HJE08033@gmail.com
and state that you both agree to participate and you agree to the answers the student has entered on the form. This will serve as a substitute for a signature.
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