EEC Malta
Educational English Culture Malta
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Host Family
Date of Visit:
Surname:
MTA License No:
Name of Host Mother:
Date of Birth:
Name of Host Father:
Date of Birth:
Full Address:
Residence Type:
Flat
House
Town:
Post Code:
Email:
Mobile No.:
Tel No.:
We prefer to host:
Boys
Girls
Any
Profession of Host Father:
I.D. Number:
Profession of Host Mother:
I.D. Number:
Boys (still living at home):
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Girls (still living at home):
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Name:
Date of Birth:
Other people living in the house:
Name:
Date of Birth:
Relation:
Name:
Date of Birth:
Relation:
Pets:
Sports:
Hobbies:
Smokers:
Yes
No
Car:
Yes
No
Has any member of the household been convicted of a serious crime?:
Is there any person living in the household having a serious illness, disability or nervous disorder?:
Accommodation Data:
Number of Bedrooms:
Number of Toilets:
Terrace/Patio:
Yes
No
Garden:
Yes
No
Swimming Pool:
Yes
No
Please enter the following captcha code:
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