Host family application form

In youth we learn;-fn age weu-n-derstand. ------- ~ - - --- - -.- Marie von Ebner-Eschenbach

Noluthando Dubazann: I just wanted to let you know that I thank you very much for giving us awonderful opportunity to host exchange students, I have experienced a lot of things with Magdalena, asa sister, a friend and a part of my family. There is nothing I miss at this point like having her around. Imiss her a lot, but at least we still keep in contact.

Marelie J van Vuuren: Dit was vir ons 'n geweldige voorreg om vir Roman te huisves. Volpunte vir julkeuringsproses. Dit het werklik vir ons gevoel of hy een van ons eie is - baie goed aangepas en welopgevoed.

Dit was vir ons as gesin 'n baie positiewe ervaring en het ons opvoedingsproses perfek aangevul omdatwereldwvsheid een van ons strewes is vir ons eie.

Blaai om vir Aansoekvorm / Application form on next page

FSA Application South African Host familiesAansoekvorm vir Suid-Afrikaanse gasfamilies

2011

Vul asseblief.alle dele in en stuur die voltooide vorm so gou moontlik terug: Faks of epos (sien onderaan bladsy 3)Sou u die makliker, papierlose opsie verkies, kan u oak die aanlynaansoek op ons webwerf voltooi.Please complete all questions and send it back as soon as possible! Fax or email (see bottom of page 3)Should you prefer the easier paperless option, you can also complete the online application on our website.

Van I Surname: .Voornaam (moeder en lof vader)First name (mother and I or father) .

Posadres: .Postal address:

Poskode: .Postal code:

Straatadres: .Street address: .

Poskode: .Postal code

Tel. (h.): f Tel. (w.): .1 .....................•....... mention mom's or dad's(meld watter ouer)

Faks: I Selfoon: .Fax Cell:E-posf email: Alternative email .

Faks. selnr en lof e-pos belangrik vir toekomstige kommunikasie met u gesin omdat slakpos soms so lank neemFax, cel nr and/or email important for future communication with your family

PLEASE COMPLETE OCCUPATION IN ENGLISH. Indien beroep sakeman/vrou of eie besigheid, meld aard van besigheidt.w.v duidelikheid. If occupation businessman I woman or own business, please mention nature of business for greater clarity

Occupation Host father I Beroepgasvader: : .

Occupation Host mother f 8eroep gasmoeder .

AL die kinders tans nog in die huis: Noem 4 of meer belangstellings per kind en omkring telkensdie geslag. (Ons Duitse kollegas weet nie altyd wie is manlik of vroulik bloat o.g.v. die naam nie)Please include all children presently living at home: Name 4 or more hobbies I interests per child.Please circle male I female of each child (not always easy to deduct gender from the names).

Naam (manlik I vroulik): Ouderdom (Junie 2011): .Name (male I female) Age (June 2011):Vier of meer belangstellings: Please write in English I Four or more hobbies I interests

Naam (manlik f vroulik): Ouderdom (Junie 2011): .Name (male I female Age (in June 2011):Vier of meer belangstellings: Please write in English f Four or more hobbies I interests:

Naam (manlikl vroulik): Ouderdom (Junie 2011): .Name (male I female Age (June 2011):Vier of meer belangstellings: Please write in English I Four or more hobbies I interests:

Naam ( manlike I vroulik): Ouderdom (Junie 2011): .Name (male I female) Age (June 2011):Vier of meer belangstellings: Please write in English I Four or more hobbies I interests:

Noem oak enige ander familie bv ouma I oupa wat by julle woon twv volledigheid .Also mention other extended family members living with the family eg grandparents

Het u enige troeteldiere? Tipe? .Do you have any pets? Kind of pet?

U voorkeur oor 'n moontlike gas: (Onthou daar is nie 100% waarborg dat u 'n gas sal kry nie omdal hulie ook deur 'nkeuringsproses gaan en daar passing tersprake is). Your preferences regarding a possible guest (A definiteplacement cannot be guaranteed as the applicants are also screened and families and applicants have to be matched).

Omkring geslag verkies Manlik 1 VroulikCircle preferred gender Male I Female

Ouderdom (omkring): 14 - 16 1 17 - 19 1 14 - 19Age (circle your choice):

Omkring asseblief AL die datumgroepe wat julle pas! Dit maak plasing van 'n gepaste aansoeker rnakliker,Please mark by circling ALL the date groups that suit your family! It makes the allocations easier.

A. Vierweek uitruilprogram I Four week program:English as well as Afrikaans schools Jul - Aug Ja/yes: Nee/no:

B. Vier weke kulturele uitruilprogram 1 Four week cultural exchange17 Dee - 12 Jan 2012 Ja/yes: Nee/no:

Cetwel slegs-min aansoekers neem-ean Desernberpl'Ogram~el·{oo~~.3(Ueenoor amlrent 1M! in Ju.!l,eU\~pro9!al11l~_ .0." ••

Note only a few students participate in the December programme (approximately 30 compared to 150 in July I Aug program) --.=------'

C. Driemaand skoolprogram = 2 groepe (skoolbywoning by dubbelmedium en Engelse skole):Three-month-school programme: (to attend English I double medium schools):Ons benodig altyd gesinne vir die lang program.

Groep/group 1: 07/04/2011 - 03/07/2011Groep/group 2: 08/07/2011 - 03/10/2011

Ja/yes:Ja/yes:

Nee/no:Nee/no:

Het u enige ander voorkeure 1 wense t.o.v u leerling? .Do you have any other preferences or wishes?

Sou dit 'n probleem wees as die leerling moontlik raok ? .Would it be a problem if the guest is a smoker?

Is iemand in u gesin self 'n raker? .Is anyone in your family a smoker?

Enige ander inligting oor u gesin wat die gas behoort te weet (bv. veqetariers): .Any other important information regarding your family (e.g. vegetarian)

Noem asb. 4 belangstellings (in English) waarvan u Duitse gas verkieslik een of meer moet he:Our German pupil should have at least one or more of the following hobbiesl interests - name 4:

Kan u u gas in Johannesburg op die lughawe kom ontvang? Omkring Ja 1 Nee Indien "Nee"Will you fetch your guest at the Johannesburg International Airport? Circle Yes I No If NO,

Na watter binnelandse lughawe moet hy 1 sy vlieg met die aankoms in SA?To which domestic airport must he I she fly on arrival in SA? .

Van watter binnelandse lughawe moet hy I sy vlieg met die vertrek terug? .From which airport will he I she fly back to Johannesburg before departure from SA?

Besoek julle dalk enige buurlande waarvoor hy 1 sy moontlik visums mag benodig? Omkring Ja 1 NeeWill you visiting any neighbouring countries, for which he I she may require a visa? Circle Yes I No

Indien ja, noem asseblief die lande I If yes, please name the countries: .

Besonderhede van u kind/-ers se huidige skooll Particulars of your child Iren's present school

Naam van die skool/: Name of the school .

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Omkring skooltaal / Language medium (circle): Afrikaans / English / Dual/Double medium:

Posadres / Postal address: .

Poskode/ Postal code: .

Tel. / . Faks / Fax: / .

Onderwyser / Teacher: .

Skoolhoof / Principal:

E-pos adres van die skool / School a-mail: .

Sal die Duitse gas 'n skoolkoshuis moet bywoon saam met u kind / ers? Omkring. Ja / NeeWill your German guest live in a school hostel with your child? Circle Yes I No

Voltooi asseblief volledig: Ons benodigkontakbesonderhedevan vriende/ familie / bure as verwysingenindienons sukkel om u by u telefoonnommerste kontak in noodgevalle.

Please complete this information: We needcontact details of friends / family / neighboursas a referenceandshould we have difficulty in contactingyou at your telephone numbers in emergencies:

Vriende se naam en van : .Name and Surname of friends

Posadres: .Postal add res:

Stad / city: .

Poskode I Postal code: .

Tel: Selnr.: .Cell number

Handtekening gasvader ISignature host father 10 nommer gasvader / 10 guest father

Handtekening gasmoeder / Signature host mother 10 nommer gasmoeder / 10 guest mother

Datum / Date

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HET JULLE DALK VRIENDEI KENNISSEWAT OOK 'N UITRUILLEERLINGSOU KON HUISVES?Elke gesin - wat vir ons 'n ekstra gasgesin wert, se naam gaan in 'n gelukkige trekking vir 'n _ete by 'ngesinsrestaurant. Die trekking vind 3 keer per jaar plaas met elke program.Naam en kontaktelefoonnommer van anderbelangstellende gesin .

DO YOU HAVE FRIENDSWHO WOULD ALSO BE INTERESTEDIN HOSTING A GERMAN PUPIL? The name of eachfamily who recruits another host family goes into a lucky draw for a meal at a family restaurant.

Name and contact number of another possible host family .

Stuur die voltooide vorm na onderstaande faks of e-posadresPlease fax or email your completed form to the fax number or e-mail address below

Tel: 011/9183281 (o/h)Faks 086 551 4377

Email: suzanne@fsa-youthexchange.co.zaWeb: http://www.tsa-youthexchange.com