Rochester ShinShinim Host Family Application

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Area Code Phone Number

First Name Last Name

	Children's names	Age	Do they live at home? (please write "college" if away at college)
1
2
3
4
5
6
7

Please include all relevant information: Name, age, gender

Beginning of Feb through End of June Interested but can't commit without learning more

Including meals, hobbies, outing, errands, etc.

	During the week	On weekends
For the adults:
For the kids:

Synagogues, schools, agencies, etc.

Strictly kosher Kosher style Definitely not kosher Vegetarian Vegan Gluten free Has someone with a serious food allergy

We are Shomer Shabbat (we are strictly observant) We do not drive on Shabbat We do not cook on Shabbat We do not use cell phones, tv and other electrical devices on Shabbat We celebrate kabbalat Shabbat and Shabbat dinners together as a family We attend Shabbat services on a regular basis We spend quality time together as a family

Who, when, how many times, etc.