EJEF Application Form Family Member 1 1: First Name 1: Surname 1: Age 1: Profession Family Member 2 2: First Name 2: Surname 2: Age 2: Profession Family Member 3 3: First Name 3: Surname 3: Age 3: Profession Family Member 4 4: First Name 4: Surname 4: Age 4: Profession Additional Information Your Full Address Including Post Code Home Daytime Mobile E-mail Do you have any pets? Yes No If yes, please state what they are, how many and where they are kept? Do you have broadband connection which students will be able to use? What are your family members hobbies and interests? How many spare bedrooms do you have? Do you have smoke alarms fitted? Yes No Is there a clear means of escape from the house in the event of fire? Yes No Do you have a fire extinguisher available? Yes No If you use gas appliances, do you have a gas check certificate? Yes No Are there any points you would like to mention which may be useful when placing students? Verify *Indicates a field you must enter.