Host Family Application

Family Information

FIRST Name (required)

LAST / FAMILY Name (required)

ADDRESS

HOME Telephone (required)

WORK Telephone

MOBILE Telephone

Your EMAIL (required)

LANGUAGES SPOKEN IN HOME
(please list):

FAMILY MEMBERS AND YEAR OF BIRTH
(please list):

PETS IF YES,
PLEASE PROVIDE DETAILS:

FAMILY ACTIVITIES, INTERESTS, HOBBIES:

SPECIAL DIET IF YES,
PLEASE PROVIDE DETAILS:

Accommodations

Student Preference (select one):
How many bedrooms do you have available for students:
Bathroom:   Smoking?
Internet:
Can the student have Internet access in your home?
What is the travel time from your home to downtown? mins

General

Do you have any Homestay experience?
If Yes, number of years:
Where did you hear about Vancouver Central Homestay?

Please provide two references, including name, phone number and relationship:
Reference #1

Reference #2

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