Please list the full name and date of birth of all children, including the child who will be participating in the exchange. Please indicate whether each child still lives at home.

Please list the name, date of birth, occupation, and relation to the family

Please list any illnesses or medications the host family should be aware of

Please indicate food allergies as well as dietary preferences (i.e., if your child is vegetarian)

Please list anything else you feel we should know about your child