Homestay Application

If you have any questions or concerns about the application, please contact Holly Rogers, Homestay Program Chair, at 319-538-6749.

Applications and attachments must be submitted by February 5th, 2024 at midnight in order to be considered for that calendar year. Applicants must be available on February 11th, 2024 for their individual interview and will be notified that afternoon whether or not they are selected. Interviews will be held at the NCSML boardroom unless applicants are notified otherwise. We ask that applicants have an active passport or have started the passport application process when submitting application for program. You may submit the form online (below) or use the paper application available here.

A completed Reference Letter Questionnaire is also required. Whether submitting an application online or via a paper application, the Reference Letter Questionnaire must be completed and submitted via email.

Name

First Name

Last Name

Date of Birth

YYYY

Full Permanent Address (City, State, Zip Code)

Phone

(###)

###

####

Parent/Guardian Name(s)

High School Attending

1. School and Extracurricular Activities

Describe, in detail, the school activities you are involved in, as well as if you participate in any volunteer activities and the hobbies you have.

2. Travel Experiences

What experiences do you have living away from home (camp, travel, etc.)? Have you traveled anywhere in the United States or abroad? What languages and what level of fluency (minimal, fair, good or excellent) do you speak?

3. Czech Ancestry & Traditions

List all parents, grandparents, etc. of Czech or Slovak ancestry. Include any details you know about them. What ethnic traditions do you and your family observe?

4. Involvement with Czech Heritage

Please list activities, past and present, that represent your involvement with your Czech or Slovak heritage.

5. Homestay Program

Why do you want to go to the Czech Republic? What do you hope to gain from this experience?

This application requires a reference (with no relationship to the student) to complete and submit the "Letter of Reference Questionnaire". This is located at the top of this webpage. By checking the box below, I agree to have my reference submit this questionnaire to the Homestay Chair. I understand that without this reference, my application will be viewed as incomplete.

I agree

I hereby declare my application is true and complete to the best of my knowledge, and furthermore, I agree to the rules of the Czech Heritage Foundation Homestay Program.

I agree

Homestay Application

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