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Accountants

CANDIDATURE DE STAGE ET HEBERGEMENT

Participant Information:

Single choice
Mr.
Mrs
Birthday

Contact Information:

Do you plan to bring your phone?
Yes
No

Emergency Contacts in origin country:

Medical Information:

Do you have any mental /physical requirements or special needs?
Yes
No

Do you have any allergies for the catagories below ? Please explain:

Food
Yes
No
Animals
Yes
No
Medical
Yes
No
Others
Yes
No
Is this your first time in America?
Yes
No
Do you have any friends or relatives living in North America?
Yes
No

If yes,

Education and Training:

University / High School

Internship Preferences:

Prefered duration
1-3 months
3-6 months
6-12 months
Preferred Season
1st Semester (Aug – Feb)
2nd semester (Feb – July)
Summer (July – Aug)

Personal Declaration:

References Academic / Professional:

Home-Stay Preferences:

This information will be used to find a good guest - host match.  However, it is not a guarantee that all of your preferences will be met

Do you prefer families or single households?
with children
No children
Single Household
No preference
Do you prefer a household with pets?
Yes
No
Do you prefer a lot of interaction with your host family?
Yes
No
Do you smoke?
Yes
No

Be honest ! If you are a  smoker, you will be required to do so outside as most host families are non-smoking. Should you cause smoking damage, you may be responsible to pay.

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