Address


Email


Telephone


Fax


Name & age of each family member in your home


Occupations

Please list the various interests hobbies
that each member of your family have.
(name each member and their interest)

What Age Group would you like to Host (tick)
13-18 19-30 30 upwards any age
mother/child(ren)


What length of time could you host?
(If you can choose more than one, please do so)

10 days 2 weeks 3 weeks 4 weeks
2 months 3 months 6 months to one year


I can host during Christmas and New Years
I can host once a year I can Host twice a year

Can you give your guest a private bedroom? yes no

What sights are near and up to
one hour away from you home


Please send photos as an email attachment as JPEG files to kandesan@gol.com, alternatively you can post them to the contact address below.