PYE Homestay Registration Form

To become a Homestay Host please complete this Registration form. All fields in bold are required.

Full Name:

How many pilgrims would you care to host? (minimum 2)

Are you happy to have Pilgrims with special needs? (A special needs team will provide assistance if required)	Yes No
Would laundry facilities be available?	Yes No
Is your home smoke free?	Yes No
Do you have pets?	Yes No
Languages spoken in your home:

Number of adults within the household:
Ages of children within the household:

Are you able to pick up pilgrims on 9 July 2008 from St Christopher’s? (pick-up time to be advised)	Yes No
Do you prefer to host	Male Female No Preference

If you would like a confirmation email, please enter the characters you see in the image:
(Hint: All letters are in lower case)

Form Design: Justin Tan