Medical Requirements
Do you have physical restrictions, impairments or allergies that will limit placement options or participation in everyday family and/or school activities?
Yes No
Pets
Please check the appropriate boxes if you CANNOT live with:
Cats
Dogs
Other Pets
Dietary Restrictions
Do you have dietary restrictions (for medical or religious reasons)?
Yes No
Smoking
Do you smoke cigarettes?
Yes No
Will abstain on AFS
If yes in smoking question, please understand that it is illegal in many countries for youth to purchase and/or smoke cigarettes. Additionally, most AFS host families will not accept a participant who smokes.
Yes No