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Vancouver Homestay Agency

Vancouver Homestay

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VANCOUVER HOMESTAY

 

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Vancouver Homestay

Brochure (English)

 

 

  

Student/Guest Application:

Please fill-out all parts of this application in order save time. We require all information to be completed to the best of your knowledge.

 
 
  • Homestay Destination
  • Applicant Information
  • Home Address

    •  Homestay Destination*
       

    Application Type
    Submitted by

    Submitter Name
    Destination (Country)

    Other Country
    Destination City/Town*

    Other City/Town
           

     Next click on Applicant Information tab é
     Applicant Information*
           
    First Name*   Last Name*  
    Male

    Female

    		 
    Citizenship*   Age*  
    Birth Date*
    Passport or ID No.*  
    Type of Visa  
    Photo (max 300K)*   (JPEG format)
       

     Next click on Home Address tab é
     Applicant Address & Contact Details*
       
    Home Address*  
    City/Town*   Province/State*
    Country*   Postal/Zip*
    Email Address*  
    Tel. Country Code*   Area Code*
    Home Phone*   Cellular/Mobile
           
     Next click on Guardians tab í
  • Guardians
  • Emergency
  • Homestay Request
  • Health Insurance

    •  Parent or Guardian Contact
       
    Parent Name
    Email Address
    Tel. Country Code Area Code  
    Home Phone Cellular/Mobile  
           
     Next click on Emergency tab  é
     Emergency Contact*
       
    Emergency Contact:*  
    Email Address*:  
    Tel. Country Code*   Area Code*
    Home Phone*   Cellular/Mobile
           
                   Next click on Homestay Request tab  é
     Homestay Request*
       
    Homestay starts*
    Homestay ends*
    Traveling Companions
    Level of Homestay*  
    Meals Plan*  
    Do you smoke?*

     

    		 Yes

    		 

    No

    		 
    Smoking outside?*

     

    		 Yes

    		 

    No

    		  N/A    
    Do you drink alcohol?  
    Home with pet    
    Any allergies?*

     

    		  

    Yes

    No

     

    		    
    If yes, caused by
     
    Any Health Condition?*

     

    		   Yes

    No

     

    		    
    If yes, please explain:
     
    Any Special Diet?*

     

    		   Yes

    No

     

    		    
    If yes, please explain
     
    Any Special Request
     
     
     
    Referred by?*  
    Referrer Name*  
         

     Next click on Health Insurance tab é
     Emergency Healthcare Insurance*
     

    Healthcare insurance coverage is obligatory, if you did not purchase your insurance.
       
    Healthcare Insurance*
       
     Next click on Hobbies & Career tab  í
  • Hobbies & Career
  • Travel Details
  • Submit Application
    •  Hobbies & Career Information*
       
    Spoken English*
    Will join a school?*

     

    		 Yes

     

     

    		 No        
    Purpose of visit*  
    Other Purpose
    School Name*
    School Address*
     
    School start date*
    Hobbies
     
    Career Goals
     
     
     Next Travel Details tab  é
     Travel Details (if available)
           
    Arrival Date Airport name/code
    Arrival Time Airline & Flight No.
    Require Airport Pickup

    Yes

     No

    		(Yes, recommended)
                 
     Next Submit Application tab  ì
     Agreements & Submit button*
               
    Do you accept our placement fee? Yes

    		No
    Do you agree to Student or Visitor Guidelines? Yes

    		No
    Do you accept our disclaimer? Yes

    		No

     

    Please complete all previous taps before submitting this application. Incomplete information will disallow this form from being sent to us. When you see our thank you page, it means that your application has been submitted.

     

    By submitting this application you acknowledge that you true and binding, and that you will allow a couple of weeks for our research and that you will check your email regularly for expected family profile or contact us to follow up.

     
     
       
     Note: click on Submit button  é
 

  

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