Greenheart Exchange Group Homestay Host Family Application Form 

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Host Family Information
Host Family Life
Host Family Members

In this section, please add all adults age 18 and above living in the home. Please start with the primary family member's information. This person will be listed as the primary contact on your application, and will receive further correspondence from Greenheart Exchange.




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ex: Mother or Father






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ex: Mother or Father





Please note that all family members 18 year and above will be required to submit an online background check.

Please add all children under 18 living in the home.





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Host Family Life Continued
Exchange Student Preferences
Hosting with GreenheartExchange 
The following people may be contacted by Greenheart Exchange for Personal References: Should not be related to host family.
Host Family Photos

 Please upload the photo in a jpeg format and limit the file size to a maximum of 5 Mb

Additional Photos

You may add up to 2 additional photos with maximum file size of 5 Mb.

 Please limit file size to a maximum of 5 Mb

 Please limit file size to a maximum of 5 Mb

Host Family Welcome Letter

Host Family Agreement

In consideration of the opportunity to be a host family, the named host(s) enters into the following understanding with  Greenheart Exchange, a non-profit student exchange organization.


Program Goals

The overall purpose of the program is to promote international goodwill and understanding by exposing young people to the cultures and values of citizens of other countries. It is expected that for students such exposure will enhance their knowledge of a foreign language, their cross-cultural skills, self-knowledge and maturity level. For hosts it is expected that such exposure will enhance their appreciation and understanding of another culture, provide them a deeper awareness and understanding of their own culture, and facilitate a potential lifelong friendship with their exchange student.


Host Obligations

Host families agree to provide their students the following:

  • Room and board for the duration of the program;
  • The student's own bed (He or she may share a bedroom with a host sibling of the same sex and approximate age. The student's bedroom must contain a separate bed for the student that is neither convertible nor inflatable in nature; and the student must have adequate storage space for clothes and personal belongings, reasonable access to bathroom facilities, study space if not otherwise available in the house and reasonable, unimpeded access to the outside of the house in the event of a fire or similar emergency.);
  • Three square meals a day;
  • Transportation to and from school and/or activities, as needed in the event that bussing is not provided by the school or school district, or transport provided by local coordinator (on group programs);
  • Close attention to the student's welfare and safety, as concerned parents would extend to their own children;
  • In an event where local, state, or federal authorities advise evacuation, host families agree to evacuate with their student to an area considered safe and keep Greenheart Exchange frequently apprised of their location and wellbeing;
  • Host family members agree that they will refrain from using cannabis products in the presence of a participant or offering cannabis products, regardless if it is prescribed and/or usage is legal in their state;
  • Host families agree not to participate in any illegal activity while hosting, or to knowingly involve or expose participants to illegal activities;
  • Host families with firearms in their possession agree to ensure that their exchange student will not have access to them at any time;
  • Host families must not provide the student with or allow the student to drink alcohol on any occasion, even if permission is given by the natural parents;
  • A sincere welcome to the student to participate in family activities as a full-fledged family member. 

Host families are also responsible for informing Greenheart Exchange of any and all material changes in the status of the host family or student, including, but not limited to, changes in address, finances, employment and criminal arrests. Host families agree to maintain auto insurance coverage on all vehicles used to transport their student(s).


Student Obligations

Students are:

  • Expected to adapt to the host family's cultural customs and values (A host family may want the student to attend one or more religious services or programs with the family. The student cannot be required to do so, but may decide to experience this facet of U.S. culture at his or her discretion.);
  • To integrate themselves into family life—including abiding by family rules;
  • For J1 High School Program and F1 Visa Program students, to integrate themselves into the high school community and succeed academically;
  • To abide by Greenheart Exchange rules and regulations, as indicated in the Conditions of Participation form signed by the student and their natural parents or guardians (Though we expect students to abide by Greenheart Exchange's Conditions of Participation regarding communication, host families cannot prohibit student from communicating with natural parents through telephone and email.);
  • To bring funds (we recommend $300 to $350 per month) to cover their personal expenses and activities.

Organizational Support

Greenheart Exchange organizationally pledges to provide its host families a Local Coordinator to orient hosts, to help them and their students adjust to the challenges of the program, to work with area high schools and to be available in case of emergency. Host families may not be working as a Local Coordinator for another sponsor organization while hosting a J1  high school student for Greenheart ExchangeGreenheart Exchange further promises to expedite communications with the recruiting and screening agencies abroad, to ensure international travel arrangements are secure, to supervise its representatives, and to monitor and evaluate the program. Additionally, Greenheart Exchange, working through its Local Coordinators, will resolve any conflicts or problems that may arise between host and student, and will, depending on the nature of the conflict or problem, find a new host family or, when such action is indicated, arrange for early repatriation of the student at the discretion of Greenheart Exchange. If a move is required, Greenheart Exchange needs 10-14 days’ notice. Our goal is to find an appropriate placement in the same community and school.


Participant Welfare

Greenheart Exchange is ultimately responsible for the welfare of students, not host families. Greenheart Exchange monitors closely all its students throughout the duration of their program.


Health Insurance

All Greenheart Exchange students carry health and accident insurance for the duration of the program.

  

Program Dates

The approximate dates of the program are:


Independent Homestay and Group Homestay: 2-12 weeks depending on the specific program

Hosts who invite students to stay for a period beyond the conclusion of the program must realize that official Greenheart Exchange sponsorship will cease and that health and accident insurance will expire.

 

Photo and Video Release Permission

For valuable consideration received, I hereby grant Greenheart International, ("Photographer"/"Videographer") and its legal representatives and assigns, the irrevocable and unrestricted right to use and publish photographs/videos of me, or in which I may be included, for editorial, trade, advertising and any other purpose and in any manner and medium; to use any photos/videos that I share with Greenheart via email, Facebook, Instagram or any other Greenheart social medial channels; to alter the same without restriction; and to copyright the same. I hereby release Greenheart International and its legal representatives and assigns from all claims and liability relating to said photographs/videos.

By checking the box and typing my name below, I confirm that I am a host parent and our family has read and agreed to the requirements, obligations, and commitment to host explained in the host family agreement. Furthermore, all members of our family agree that this is a worthwhile experience, that we wish to host a Greenheart Exchange student, and that we are financially able to host.