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Billet Application



 

Product Code: BILLET


Husband's Legal Name*:


Husband's Date of Birth*:


Husband's Birthplace*:


Wife's Legal Name*:


Wife's Date of Birth*:


Wife's Birthplace*:


Home Address*:


# of Yrs Living in Phila/South Jers*:


Previous Mailing Address:


Current Home Phone Number*:


Husband's Mobile Phone Number*:


Wife's Mobile Phone Number*:


Husband's E-Mail Address*:


Wife's E-Mail Address*:


Best Way To Contact Husband*:


Best Way To Contact Wife*:


Husband's Employer & Occupation*:


Husband's Employer's Address*:


Husband's Work Phone Number*:


# of Yrs with Current Employer*:


Wife's Employer & Occupation*:


Wife's Work Phone Number*:


# of Yrs with Current Employer*:


Name and age of Child 1:


Gender of Child 1:
  

Name of Child 1's School:


Is Child 1 Currently Living there?:
  

Name and age of Child 2:


Gender of Child 2:
  

Name of Child 2's School:


Is Child 2 Currently Living there?:
  

Name and age of Child 3:


Gender of Child 3:
  

Name of Child 3's School:


Is Child 3 Currently Living there?:
  

Does anyone else live with you?:
  

Do you have any pets?:
  

Have you ever hosted a player?:
  

How many are you willing to house?:
  

What are your work schedules?*:


What chores would the player have?*:


What accommodations are available?*:


Will the player have his own room?*:
  

Will the bath room be seperate?*:
  

How far is your house from IceWorks:


Still billet if player was traded?:
  

If yes, would you host a new player:
  

Do you have internet access?:
  

Name of reference #1*:


Reference #1 mailing address*:


Reference #1 Phone Number*:


Reference #1 Relationship to you*:


Name of reference #2*:


Reference #2 mailing address*:


Reference #2 phone number*:


Reference #2 relationship to you*:


Name of reference #3*:


Reference #3 mailing address*:


Reference #3 phone number*:


Reference #3 relationship to you*:


Qty:  
Description
 
We want you! Become a billet family for the Philadelphia Little Flyers. Host families are needed for the 2016-17 EHL Little Flyers Season. Receive $400 a month!

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