Application Form

Communication in Homestay is very important. Please make yourself available to have conversations with your Homestay family – the way to improve your English and to learn about Canadian culture.

If you are interested in applying for Homestay Accommodation with one of our families, please fill out the application below and we will contact you within 2 business days:

Application for Homestay Accommodation in Vancouver, Canada


Personal Information

  Full Name     Email

Telephone Number     Nationality

Date of Birth -     Year       Month       Day  

Home Address

Native Language        If Other  

What Best Describes Your Current Level of English?
 Introductory Elementary Intermediate Advanced

Are You Currently a Student?
 Yes No    If Yes, What Level?

If you are not a student, please provide your occupation:  


Program Information

School Name  

School Address

Program Begins:      Month    Day    Year

Program Ends:         Month    Day    Year


Homestay Information

The dates of the homestay are independent from the dates of the program

Homestay to Begin:    Month    Day    Year

Homestay to End:       Month    Day    Year

Do you require airport pick-up?    No Yes

Airline     Flight #  

Arrival Time:      Month      Day      Hour      Minute

Departing From Which City?  



Homestay Preferences

Are You a Vegetarian?  Yes No

List All Foods Which You Cannot Eat:  

Do You Smoke?  Yes No

I Prefer a Home  With Children Without Children No Preference

I Prefer a Home  With Dogs Without Dogs No Preference

I Prefer a Home  With Cats Without Cats No Preference

Hobbies  


Medical

Allergies  

Medications  

Disabilities or Conditions  



Emergency Contact Information

Emergency Contact Name  

Emergency Contact Telephone Number  

Emergency Contact Relationship to you  


Special Instructions