Host Family Application - Homestay Select +

First Name *

Last Name *

Street Address *

Apartment, suite, etc

City *

Province *

Postal Code *

Home Phone *

Work Phone

Cell Phone

Email Address *

Names of residents living at home, their relationship, and year of birth *

Occupation and Employer *

Full-Time or Part-Time *Full-TimePart-Time

Spouse's Occupation and Employer

Full-Time or Part-TimeFull-TimePart-Time

Residence *HouseTownhouseApartment

What language(s) are primarily spoken in your home on a daily basis? *

Are there any health, safety, or accessibility factors in the home that could affect a student’s stay (e.g., mobility considerations, service animals, noise sensitivities)? *

To comply with student safety requirements, are there any criminal convictions that would legally prevent you from hosting a student? *

Do you have any family pets? If so, please specify:

Name a few of your family’s interests and hobbies: *

Student Preference *MaleFemaleEither

Would you allow a student to smoke outside your home? *YesNo

Are you able to host students with special diets (such as vegetarian, vegan, etc.)? *YesNo

Which kind of student accommodation will you provide? *SingleTwin

Have you ever hosted before? If so, please tell us about your experience:

What are your reasons for hosting? *

List two personal or business references below: *

Do you know anyone else who may be interested in hosting?

The completion of this application does not confirm the placement of any student(s) in your home.