New York Accommodations Centre
---- Housing Application ----
Complete all information in English by typing on this form

  Male: Female:
Todays Date: 05/02/2025

Your Data:
Family Name: 
First Name:  
Middle Name:  
Street Address:  
City:  
Country:  
State:  
Province:  
Postal Code:  
Date of Birth:  
 / / (month / day / year)
Telephone:  
Email:  
School and address or activity while in USA:  
Fax:  
 
Languages you speak:
English Ability:
 
How Long will you
need housing:
 # of Nights
Do you need airport
pick-up?
 
Arrival Date:  
 
Departure From NY Date: 
 
Arrival US Airport:  
 
Airline Name:  
 
Flight #:  
 
Arrival Time:  
 
Departing Country Airport: 
 
Direct Flight:  
     
Accommodation:
  Would you accept a host with children under the age of 6?
  Would you be comfortable in a home that has indoor pets?
  Do you smoke?
     
  Please list any allergies, health problems or foods you cannot eat then tell us about yourself.
Hobbies, sports, activities, interests, goals are good items to describe you to your host family.
 
Allergies: 
 
Health:  
 
Food:  
 
Goals:  
 
Hobbies:  
 
Sports:  
 
Activities:  
 
Interests:  
 
 
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