Vancouver Homestay Agency

Host First Name:

Last Name:

Street Address:

City:

Postal Code: 

Home  Phone:

Cell:

Email:

*Important: Please recheck your email and phone number for any typo.

Describe the room(s) that will become available:

Please include information about availability of window, balcony, night table, lamp, desk, chair, closet, mirror, TV, clock Radio, Internet access, computer, telephone...etc Please include room size in square foot and bed size (twin, double, or queen).

Room Location: i.e.

Basement/Main Floor/2nd Floor

/3rd Floor/Other

Bathroom:    Private

Shared

If shared bathroom, how many people share the bathroom?

Yes:

    No:   If yes, how many pets?

Describe Pet(s):