Homestay Application TWIST High Performance HockeyConditioning Camps Welcome Twist Camp Participant! First Choice International Placement Inc. is pleased to work in partnership with Twist Conditioning Inc. to arrange homestay accommodation for athletes who will participate in the upcoming High Performance Hockey Conditioning Camps. To help us find the most suitable host family for you during your stay please take a few moments to complete the form below. After submitting the form you will be contacted by our representative to confirm your homestay requirements. Sincerely Management and Staff First Choice International Placement Inc. Participant Information Please note that all of the fields below must be completed in order to process an application. Your cooperation is appreciated. Last Name: Given Names: Preferred Name: Gender: select==> Female Male Date of Birth: mm -> _____ Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec dd -> _____ 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 yyyy -> _____ 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1980 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2010 Current Age: years Address: City: State/Province: Country: select -> _____ Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire (Ivory Coast) Croatia (Hrvatska) Cuba Cyprus Czech Republic Czechoslovakia (former) Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France (Metropolitan) French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain (UK) Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (North) Korea (South) Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda S. Georgia and S. Sandwich Isls. Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Pierre and Miquelon Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay US Minor Outlying Islands USSR (former) Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zaire Zambia Zimbabwe Zip/Postal Code: Telephone: Email: Parent or Legal Guardian Contact Information Parent Last Name: Parent First Name: Phone (Day): Phone (Night): Email Address: Expected Arrival and Departure Dates for Homestay Arrival Date: Month -> _____ Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day -> _____ 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2011 2012 2013 2014 2015 Approximate Time -> _____ morning afternoon evening Departure Date: Month -> _____ Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day -> _____ 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 2010 2011 2012 2013 2014 2015 Approximate Time -> _____ morning afternoon evening Homestay Preferences Type of Host Family: No preference regarding the type of family Family with children Family with teenagers Family with no children or teens Have you stayed with a host family at a previous camp who you would like to stay with again? If yes, please provide the following: Family Name: Phone: Pet preference: No preference regarding pets No pets Dogs only Cats only Roommate Preferences As there may be opportunity to accommodate more than one Twist Camp participant in a homestay who would you want to have as your roommate(s): Requested Roommate #1: Requested Roommate #2: Medical Information Please list any allergies, special medications, or health problems: Additional Placement Considerations Name some of your favourite foods: Name some of your least favourite foods: What is your favourite meal of the day? Why? Do you have a favourite comfort food that you enjoy when you are not feeling well? If so, what? Describe some of your hobbies and interests: Do you have a pet peeve? If so, what? How would you describe yourself to someone? Very assertive Somewhat assertive Somewhat shy Very shy Do you generally like to surround yourself with people or do you prefer to spend time alone? Prefer people Prefer solitude Do you generally like to discuss your problems with people or do you solve your problems on your own? Discuss with people Solve alone If you were to change one thing about yourself what would it be? In one word describe yourself as a player: In one word describe yourself as a person: As a player what is your strongest attribute? As a person what area do you need to improve on? Who are the biggest influences in your life? Why? Describe up to three qualities that your parents have instilled in you? Additional Comments:
First Choice International Placement Inc. is pleased to work in partnership with Twist Conditioning Inc. to arrange homestay accommodation for athletes who will participate in the upcoming High Performance Hockey Conditioning Camps.
To help us find the most suitable host family for you during your stay please take a few moments to complete the form below. After submitting the form you will be contacted by our representative to confirm your homestay requirements.
Sincerely Management and Staff First Choice International Placement Inc.