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Post-Acceptance Forms

Housing: Santiago, Chile

Please Note:

You may also download and print the pdf version of this form and mail it to us.

Use the TAB key or your mouse to move between fields. Hitting the ENTER key will submit the form.

Photo

All students are required to supply a photo. This photo should clearly show a full face, front view and open eyes.

Select Photo:

Program information

Country

Program

Semester

Fall

Spring

Summer

Year

Personal Information

First Name

Last Name

Age

Sex

Male

Female

Home Address

Home University

Major

Academic information

What is your academic major?

What are your academic interests?

Have you studied Spanish?

Yes

How long?

Evaluate your knowledge of Spanish and any other foreign language you speak:

Housing Information

Dietary

Vegetarian:

Yes

Additional specific foods you do not eat:

Specific foods you are allergic to:

Please note: Chilean meals generally consist of meat and/or pasta, rice, beans and _salad. Few households will be prepared to accommodate diets that cannot include some of these staples.

Medical

Do you have allergies to animals

Yes

If yes, specific details

Other Medical Requirements:

Please note: Chile is very much a "smoking" society. Although ever attempt will be made, it may not be possible to locate a non-smoking homestay.

Do you smoke?

Yes

If yes, how often

Regularly

Sometimes

Ocassionally

Do you mind living in a home where one or more of the family smokes?

Yes

Please note: It may be the custom of some homestay families to have wine with dinner. The following questions aim to determine your preference regarding moderate consumption of alcohol.

Do you drink alcoholic beverages?

Never

Sometimes

Often

Would you mind living with a host who drinks alcohol in moderation?

Yes

Do you actively practice a religion?

Yes

If yes, please state your religious affiliation:

Do you mind living with a family with a different religious affiliation than yours?

Yes

Do you consider yourself to be:

Extremely Outgoing

Moderately Outgoing

Moderately Reserved

Fairly Introverted

Please explain your answer:

What do you hope to gain or achieve from your homestay experience in Chile? Please be specific.

What would you like your Chilean hosts to know about you? Special interests or hobbies?

If you have special concerns about your housing assignment, or if there is anything else you would like to tell the housing coordinator in Santiago concerning the most appropriate accommodation for you, please describe it on a separate sheet.If you have additional questions, please call the SU Abroad office at 1-800-235-3472, or send e-mail to Stella Zemlin at szemlin@syr.edu.

In submitting this form, I understand that, in an effort to achieve an appropriate homestay situation for students, SU Abroad may share this form (or the information on this form) with my host family.