Home Telephone. Student’s mobile: Student’s email: Parent’s email: Date of arrival to NZ (if known): Homestay start date: Flight details (if known): People travelling with the student (if any): Personal Details Please give the correct response to each question How many people are in your family? How many siblings do you have? Who do you usually live with? What are your siblings’ names and how old are they? Would you like children in your homestay? ⬜ Yes – please tick which age group below ⬜ No 0 – 5 years ⬜ 6 – 12 years ⬜ Other teenagers ⬜ What jobs do your parents have? Mother Father Is there any food you cannot eat? If yes, please provide details. What are your favourite foods? Do you like cats? ⬜ Yes ⬜ No Dogs? ⬜ Yes ⬜ No What pets do you have? Do you smoke? ⬜ Yes ⬜ No What interests or hobbies do you have? ⬜ Music ⬜ Movies/TV ⬜ Reading ⬜ Outdoor Activities ⬜ Travel Please list any others: Do you attend a church or place of worship regularly? ⬜ Yes ⬜ No If yes, please provide details What sports do you play? What instruments do you play? What interests does your family have? Are you allergic to anything? If yes, please provide details. Any other special requirements? What is your personality type? Please circle where you think you fit on the following scale where 5 = a very extrovert personality and 1 = a very introvert personality 5 4 3 2 1 Please add any other personal details that would help us better match you with a homestay family.
Home Telephone. How Long in Business: Drivers License #: Social Security Number: Associated Companies: BUSSINES REFERENCES – Please include any other equipment rental company where you have an account Bank name: Address: Account No.: Contact: Telephone: MAJOR SUPPLIERS: Name: City: Telephone:
Home Telephone. Home Facsimile: Please DO NOT contact me at mailing address or phone. You may also contact me by e-mail at: CREDIT CARD INFORMATION (FOR RETAINER PAYMENTS ONLY) Credit Card Information: Visa MasterCard Amex Name on Card: Card No: Expiration Date: Your Billing Address for Card: Amount Authorized: Authorization Signature: Date Authorized:
Examples of Home Telephone in a sentence
Home Address Home Telephone PSC NO: 9 GAS SECTION: 0 LEAF: 92 NATIONAL FUEL GAS DISTRIBUTION CORPORATION REVISION: 1 INITIAL EFFECTIVE DATE: 05/01/2017 SUPERSEDING REVISION: 0 ISSUED IN COMPLIANCE WITH ORDER IN CASE NO.
Print Name Sign Name Social Security Number Home Telephone Number Subscribed and sworn to me this day Of , A.D. My Commission Expires .
Address City Zip Code Home Telephone Business Telephone Office Sought District No.
ORUnderemployed status:I certify that based on the attached chart (Income Eligibility Guidelines), I am underemployed..AND Print Name Sign Name Social Security Number Home Telephone Number Subscribed and sworn to me this dayOf , A.D. My Commission Expires .
Name, Title and Home Address of company owner(s) if sole proprietorship or partnership: Name Title Home Address Home Telephone Name Title Home Address Home Telephone Name Title Home Address Home Telephone 9.
More Definitions of Home Telephone
Home Telephone. Email: Cell Phone:
Home Telephone. Student’s mobile: Student’s email: Country of birth: Country of citizenship: First language: Other language(s): Passport number: Country of issue: Passport issue date: Expiry date:
Home Telephone. Email: Facility Requested: Date Requested: Time Requested: open: close: (Please allow time for set-up & decorating as well as take down and clean up within your open/close times. Parties may not arrive before the open time to decorate and must be off the property at the close time.) Type of function: Approximate number of quest expected: (Maximum Group Size: Recreation Building-120 Administration Building-50) Facility Resident First 3 hours Resident Add. hours Non-Resident First 3 hours Non-Resident Add. hours Deposit (Refundable) RECREATION BLDG $ 100.00 $ 30.00 $ 135.00 $ 30.00 $ 150.00 ADMINISTRATION BLDG $ 60.00 $ 25.00 $ 80.00 $ 30.00 $ 100.00 ADMIN-KITCHEN $ 30.00 $ 5.00 $ 30.00 $ 5.00 Fees should be paid with two separate checks for bookkeeping purposes. Deposit is due at the time of the booking. Rental payment is due no later than two weeks before the rental. Signature of Applicant/Date Agent, Genoa Township Park District/Date For Office Use Only Date Deposit Received Amount Cash/Check # Date Rental Fee Received Amount Cash/Check # 000 Xxxx Xxxxxx Xxxxxx, Xxxxx, XX 00000 • 815/000-0000 FAX 815/000-0000 xxx.xxxxxxxxxxxxxxxxxx.xxx This is an agreement between the Genoa Township Park District and the “responsible party” for the use of the facilities in Xxxxxxxxxxx Park, 000 Xxxx Xxxxxx Xxxxxx xx Xxxxx, XX. We the aforementioned do hereby agree to the following terms and conditions as set forth by the Genoa Township Park District. These regulations are to be followed to assure their refund of the re- sponsible party's deposit. Responsible Party:
Home Telephone. Cell Phone: Email Address: Would you like to be on our newsletter list? Yes No Emergency Contact Name & Relationship : Phone: Accommodation or address the night before your trip (for van shuttle) – i.e. where to pick you up! Kayaking Information: Kayak preference? Single Double Either Both Kayaking experience? Not Yet Tried Day Trips Multi-day Intro Course Kayaking ability? None Beginner Intermediate Advanced Swimming ability? None Beginner Intermediate Advanced Trip Name & Dates: Height: Weight: PFD / jacket size? (unisex) Child XS Small Med Large XL XXL I will bring my own What is your: Participation Agreement & Permission to Publish: I understand that in the event of inclement weather, or any other condition that threatens the safety of the participants, West Coast Expeditions reserves the right at any time, to alter the itinerary of the trip package or expedition, without penalty or obligation to refund any amount paid by the participants. I understand and fully accept that West Coast Expeditions reserves the right at any time to refuse, without penalty or any obligation to refund any amount paid, continued participation in an expedition by any person who in the sole discretion of the trip guides becomes a hazard to themselves or other members of the trip or expedition. I hereby acknowledge that West Coast Expeditions and other participants of this trip or expedition may record my participation in this expedition using film, video, digital photography, writing, or other methods and I consent to the foregoing taking place. PARTICIPANT SIGNATURE: DATE (D/M/Yr): Parent or Guardian signature if participant is under age 19: West Coast Expeditions 1 (250) 338-2511 or 1-800-665-3040 Medical Information Dietary: We strive to offer you a deliciously memorable wilderness food experience. We do our best to accommodate your dietary restrictions, but please keep in mind that we cannot guarantee that traces of allergens will not be present in food preparation areas. If you have severe or anaphylactic allergies please contact us to discuss how best to meet your needs. I cannot eat: (check all that apply) Poultry Seafood Shellfish Fish Beef Pork Cooked eggs Eggs in baking Dairy Dairy in baking Wheat Gluten Please describe specifics about your dietary restrictions: Appropriate substitutes: Medical Conditions: Please circle YES or NO for each item. If answering YES to an item, please provide further ...
Home Telephone. Cell Phone: Child’s Date of Birth:
Home Telephone. Work Telephone: Fax: Cellular: Contact E-mail Address: Social Security Number or Tax Identification Number: MANAGER: Artista Property Management, LLC By: Name: Title: Agent for Manager ADDENDUM A ASSIGNMENT AND ASSUMPTION OF UNIT RENTAL MANAGEMENT AGREEMENT “MANAGER” Artista Property Management, LLC “SELLER” Name: Address: “PURCHASER” Name: Address: Phone: Fax: “UNIT” Rhapsody Condominium Unit # “SALE DATE”
Home Telephone. Cell Phone: ________________________ Email Address: ____________________________________________________________ Month/day of birth: _____ / _____ / XXXX Emergency Contact Name: _____________________ Number:______________________ Place of Employment: _____________________ Position:__________________________ Days and hours of employment:_______________________________________________ Educational History/Schools Attended/Degrees: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ Prior Yoga Trainings and certifications: _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ _____________________________________________________________________________________________