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Homestay Application
New application Update

Family Information
Family Name:
 First Name:
 
Host Father
Host Father's Name:
Birthday:
Occupation:
  
 
Host Mother
Host Mother's Name:
Birthday:
Occupation:
  
 
Other Family Members
Name:

Male Female


Male Female


Male Female


Male Female

Birthday:

Address Information
Home Address
   
Suburb:
 Postal Code:
 
Postal Address
If same as home address leave blank
   
Suburb:
 Postal Code:
 
Phone #:
 		Fax #:
Father Contact Phone #:
   		Mother Contact Phone #:
  
Email:
  

House Details
Student Bedroom Details
Bedroom 1
Single room
Shared room

Private bath
Bedroom 2
Single room
Shared room

 Private bath 		Bedroom 3
Single room
Shared room

 Private bath
 
House Information
Primary language spoken in the home:
 
Other language spoken in the home:
 
Check all that apply:
Internet No Smoking   Dogs(s)
Pool Smoking Outside Cat(s)
Piano Smoking Inside   Other Animals:
Travel time to school:
< 10 minutes
 40 minutes > 60 minutes
20 minutes
 50 minutes  
30 minutes
   60 minutes  

Which bus/buses do the students use to get to the school:
  School address: 1477 West Pender, Vancouver, BC
 
Letter to student
Introduction to your family along with a description of your home. (sample letter)
   

Student Details
Students Preferred:
Male
Female
Either 		Check all that apply:
Adult students ok
Teenage students ok
Children ok
 
 
Please list any unique features of your household (eg. religion, diet, special needs, lifestyle etc) that you feel the student should be aware of:
* I have read and agree to the Homestay Guidelines / Homestay Information

* Please email our homestay coordinator at with photos of your family and home. It is required that we have photos of your family and home.