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Mid-Continent University

99 Powell Rd. East

Mayfield, KY 42066

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School for Global Business English

270.247.8521, ext. 374

fax: 270.247.3115
 

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ESL Homestay Student Application Form

Date:
Name:
City:
Country:
Gender: Female
Male
Date of Birth (Month/Day/Year):
Email Address:
Do you have a valid International Driver's License:
List any allergies (including foods,animals- cats,dogs):
Health problems:
Foods you cannot eat:
Do you smoke?
Describe what you are currently doing in your country (for example: university student, working in a company, etc.)
Describe your special interest and hobbies.
Is there anything else you would like to say about yourself and your homestay preferences?
Clicking the “I Agree” box certifies I understand and accept the “Homestay Guidelines for Students.” I agree

 

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CONTACT US

Mid-Continent University
99 Powell Road East, Mayfield, KY 42066 270-247-8521
Adult Degree Program – 888-MCU-GRAD (888-628-4723)
Traditional Admissions – 866-894-8878