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Homestay in Vancouver
Host Family Application
Please fill-out all fields in this application in order to VHA to assist you. This information will remain confidential and will be accessed only by VHA for the sole purpose of homestay placement.
For student homestay application, please click here
Applicant
First Name:
Last Name:
Occupation:
Spouse
Home address:
Street Address:
City:
Postal Code:
How can we contact you?:
Home Phone:
Cell:
Email:
*Important: Please recheck your email and phone number for any typo.
Family members:
Adults:
Children:
Do you have any children?
Age:
Male: Female:
Describe the room and in-room amenities:
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?
Important: if you have some digital photographs of room and other photos that can help us, please email them separately to
Do you have pets?
Yes:
No: If yes, how many pets?
Describe Pet(s):
Transportation information from your home:
Do you prefer to accommodate males or females?
Females Males Both
What age group are you able to host?
10 - 15 16 - 18 19 - 25 26 & Older
Do you smoke?
No:
Is your family in good health?
Yes No; please explain
Are there frequent overnight guest(s)? Yes No
Are you able to host a student with a disability? Yes No
If yes, describe?
Do you accept a smoker in your home?
What languages do you speak at home?
1st Language
2nd Language
What are your family hobbies?
Do you have any comments that you wish to add? Please indicate the best time of the week to meet with you and the family!
Describe your neighborhood: How close are you to schools, colleges, universities, shopping, transportation, entertainment, etc.? Please name schools and distances in kilometres if possible.
Homestay experience? Yes No
If Yes, number of years:
How did you hear about us? If you found us on the Internet, which search engine did you use and what did you type?
By submitting this application you agree to:
Host Family Guidelines Yes No
10% agency commission Earnings. Yes No
monthy and weekly Rates Yes No
meet with us and show us your home, Yes No
criminal record check upon request. Yes No
Do you accept our disclaimer? Yes No
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