home stays Canada for ESL and foreign students

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Home Stay Application
Please fill in the following information and you will be contacted by HomeStays Canada

First Name: Last Name:

Address:

City: Province:

Postal Code:

Home Phone: Business Phone:

Email:

Please fill in the following information about your home.

Area of City:

Type of room(s) available:

Bathroom(s):

Family Members and Ages:

Employment/Business :

Hobbies:

Languages spoken in home:

Is internet access available to students:

Which daily meals are provided:

Family Pets:

Smoking Household?

Are you willing to obtain a criminal record check?

Please fill in the following information so we can match a visiting person with you.

Religion Preference:

Male or Female Preferred:

Age Range of Students Preferred:

Please give a brief description of your family life and activities. This information will be sent to the person coming to your home.

Write further comments here.

Submitting this form to Home Stays Canada does not constitute a legal binding agreement. This is the first step in the process to be considered a host family.