Host Family Home visiting Checklist

@include('partial.input', array( 'layout'=>'','size'=>'', 'id'=>'inputHostfamilyName', 'title'=>'Host family Full name', 'maxlength'=>'40' ) ) @include('partial.input', array( 'layout'=>'','size'=>'', 'id'=>'inputHostfamilyAddress', 'title'=>'Host family address', 'maxlength'=>'150' ) ) @include('partial.dateform', array( 'id'=>'selectHomevisitDate', 'title'=>'Home visiting date' ) ) @include('partial.radio', array( 'size'=>'col-xs-4', 'class'=>'radioRequired' , 'name'=>'about18member', 'title'=>'Has anyone in the Host Family home moved IN /OUT or turned 18 since submitting the Host Family application? *Please make sure to write the detail of international student whom they are hosting from other agency. (Agency name, student name, gender, grade) ', 'radioContents' => ['Yes'=>'Yes', 'No'=>'No'] ) ) {{-- Number of Member --}} {{--household member--}} @for ($j = 1; $j <= 10; $j++)
1)class="mt30"@endif style="display:none;">

Member #{{$j}}

@include('partial.input', array( 'layout'=>'mt15','size'=>'col-lg-6', 'id'=>'inputNameOfMember_homevisit'.$j, 'title'=>'Full Name (*max character length : 40)', 'maxlength'=>'40' ) )
@include('partial.dateform', array( 'id'=>'selectBirthOfMember_homevisit'.$j, 'title'=>'Birthday' ) )
@include('partial.input', array( 'layout'=>'','size'=>'', 'id'=>'inputRelation_homevisit'.$j, 'title'=>'Relation (*max character length : 15)', 'maxlength'=>'15' ) ) @include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'radioLiveWithMember_homevisit'.$j, 'title'=>'Does the member live with you?', 'radioContents' => ['Yes'=>'Yes', 'No'=>'No'] ) )
@endfor
Please insert student’s room photo in 2 different angles here. Also, please insert photo of you and host family together at the home visiting day.
@include('partial.fileupload_empty', array( 'layout'=>'','size'=>'col-lg-6', 'id'=>'inputFile_StudentRoomPhoto1', 'title'=>'Student room Photo1' ) ) @include('partial.fileupload_empty', array( 'layout'=>'','size'=>'col-lg-6', 'id'=>'inputFile_StudentRoomPhoto2', 'title'=>'Student room Photo2' ) )
@include('partial.fileupload_empty', array( 'layout'=>'','size'=>'col-lg-6', 'id'=>'inputFile_LCandHostfamilyPhoto', 'title'=>'LC and Host family Photo 3' ) )
@include('partial.radio', array( 'size'=>'col-xs-6', 'name'=>'confirmReviewInstruction', 'title'=>'Has Host Family logged on and reviewed basic instructions for online account? Please review and confirm their online application, agreement and Criminal background check request form together while you are there.', 'radioContents' => ['Yes'=>'Yes', 'No'=>'No'] ) ) *Website: www.anbeducation.us
@include('partial.input', array( 'layout'=>'','style'=>'padding-left:0px;','size'=>'col-lg-6 mt15', 'id'=>'inputHostFatherSignName', 'title'=>'Host father name', 'maxlength'=>'40' ) ) @include('partial.dateform', array( 'layout'=>'col-lg-6','size'=>'', 'id'=>'inputHostFatherSignDate', 'title'=>'Date' ) )
Host father signature
inputSignImg1)) src="{{ ( ! empty ($my_application->inputSignImg1) ) ? $my_application->inputSignImg1 : '' }}" @endif>
@include('partial.input', array( 'layout'=>'','style'=>'padding-left:0px;','size'=>'col-lg-6 mt15', 'id'=>'inputHostMotherSignName', 'title'=>'Host mother name', 'maxlength'=>'40' ) ) @include('partial.dateform', array( 'layout'=>'col-lg-6','size'=>'', 'id'=>'inputHostMotherSignDate', 'title'=>'Date' ) )
Host mother signature
inputSignImg2)) src="{{ ( ! empty ($my_application->inputSignImg2) ) ? $my_application->inputSignImg2 : '' }}" @endif>
@include('partial.input', array( 'layout'=>'','style'=>'padding-left:0px;','size'=>'col-lg-6 mt15', 'id'=>'inputLCSignName', 'title'=>'Local coordinator name', 'maxlength'=>'40' ) ) @include('partial.dateform', array( 'layout'=>'col-lg-6','size'=>'', 'id'=>'inputLCSignDate', 'title'=>'Date' ) )
Local coodinator signature
inputSignImg3)) src="{{ ( ! empty ($my_application->inputSignImg3) ) ? $my_application->inputSignImg3 : '' }}" @endif>
@include('partial.save')