Family Information

SURNAME: (required)
GIVEN NAME: (required)
ADDRESS
CITY:
POSTAL CODE:
HOME Telephone: (required)
WORK Telephone
MOBILE Telephone:
EMAIL: (required)
DATE OF BIRTH (dd/mm/yy):
OCCUPATION:

List all members living in your home

Full Name:
Gender:
DOB (dd/mm/yy):
Relationship:
Occupation:

Additional Family Members (Please list all family members residing in the home. Please note DOB and relationship.)

Pet Information*

PETS

IF YES, PLEASE PROVIDE Type, Size and Breed:

Family Activities, Interests, Hobbies (please list)

Languages*

LANGUAGES SPOKEN IN HOME
(please list):
WHAT LANGUAGE IS SPOKEN PREDOMINANTLY?
(please list):
Vancouver Central Homestay Ltd. requires that all family members speak English only in the student’s presence.

 

Diet Information

Families are expected to provide three healthy, adequate meals a day for the students and easy access to snacks. Students should eat dinner with the family.
DO YOU HAVE ANY SPECIAL DIETARY PRACTICES OR RESTRICTIONS?

Accommodations

STUDENT PREFERENCE (select one):
How many private BEDROOMS do you have available for students?
BATHROOM:
SMOKING?
INTERNET:
Can the student have Internet access in your home?
What is the TRAVEL TIME by bus from
your HOME to DOWNTOWN VANCOUVER?
Mins:
What is the TRAVEL TIME by bus from
your HOME to SFU, BURNABY?
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
Please enter the following code: captcha

This 'code' is to validate that you are a person & not an Internet spambot.

 

 

After completion of a home interview, Vancouver Central Homestay Ltd. requires the applicant and all residents (who are 19 years or older) in the household to provide a current criminal record check and will require a new criminal record check every 3 Years. Vancouver Central Homestay Ltd. will NOT PAY for the fees required for the criminal record check. If your criminal record check returns with a negative reply, we will not be able to provide you with students, nor will Vancouver Central Homestay Ltd. be responsible for reimbursement of the fees. (See the following link for further details: http://www.rcmp-grc.gc.ca/en/criminal-record-and-vulnerable-sector-checks).