Zone 2*Zona 3*Zone 4*Zone 5*
Are you happy to live with a host family who has children?*
Are you happy to live with a host family who has pets?*
Are you happy to live with a host family who smokes in the home?*
Age *
Do you smoke?*
Are there are any special dietary requirements?*
Do you have allergies? If so, please state which*

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