Host 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. Please follow the tabs starting with the "Primary Host"

• Primary Host
• Second Host
• Home Address
• Household
• Preferences

Primary Host*
		(* ) Required	(**) Recommended
Application Date
First Name*		Last Name*
Occupation*		Gender**	select female male
Email*		Home Tel*
Cellular**		Work Tel**
Age Group**	select 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-80 81+	Marital Status**	select married com. law single
Do you drive?**	select yes no	Driver Licence*
Next tab "Host two" é

Second Host* (adults only who shares household duties)
All fields(*)		Required(*)	(**)Recommended
First Name*		Last Name*
Occupation*		Relationship**	select husband wife boy friend girl friend brother daughter son sister mother father cousin niece grand father grand mother
Age Group**	select 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-80 81+	Cellular**
Next tab "Home Address" if any! é

Home Address & Contact Details*
All fields(*)		Required(*)	(**)Recommended
Street Address
City		State/Province
Country	select country Canada U.S.A. U.K. ------------ Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Botswana Brazil British Virgin isl. Brunei Bulgaria Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Irak Iran Ireland Ireland, Northern Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Rwanda Saba Saipan Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Trinidad-Tobago Tunisia Turkey Turkmenistan United Arab Emirates U.S. Virgin Islands U.S.A. Uganda United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Yemen Zaire Zambia Zimbabwe	Postal Code
		.
Next tab "Household" é

Household (Number of occupants, accommodations, spoken languages, etc...)
All fields(*)		Required(*)	(**)Recommended
Type of home	select house town house town home apartment condo ranch farm	Home Condition	select new renovated fairly new newly renovated Needs renovations
Adults	select one two three four	Children	select one two three four five none
Students	select one two three four five none	Pets	select one two three four five none
Guestrooms	select one two three four five none
Guest suites	select One bedroom suite Two bedroom suite Three bedroom suite
First Language	select English French -------- Arabic Bulgarian Catalan Chinese (S) Chinese (T) Croatian Czech Danish Dutch English Estonian Finnish French German Greek Hebrew Hungarian Icelandic Italian Indonesian Japanese Korean Latvian Lithuanian Norwegian Persian Polish Portuguese Romanian Russian Serbian Slovak Slovenian Spanish Swedish Turkish	2nd language	select English French None -------- Arabic Bulgarian Catalan Chinese (S) Chinese (T) Croatian Czech Danish Dutch English Estonian Finnish French German Greek Hebrew Hungarian Icelandic Italian Indonesian Japanese Korean Latvian Lithuanian Norwegian Persian Polish Portuguese Romanian Russian Serbian Slovak Slovenian Spanish Swedish Turkish
Any Smokers!	select yes, smoke outside yes no	Family Health	select excellent good some challenges some concern
Activities		Hosted before!	select yes no
& hobbies		Smoke detector	select yes no
Next tab "Preferences" é

Hosting Preferences (why do you wish to host or who do you prefer to host)
All fields(*)		Required(*)	(**)Recommended
Why would you like to host students or house guests?
Prefer hosting	select males females both	Meals preference	select **three meals **bkfast and dinner breakfast and lunch lunch and dinner dinner lunch breakfast no meals
Ages 12  to 18 yrs.	select yes no	Ages 19 and older	select yes no
Accept couples	select yes no	We accept smokers	select yes, smoke out yes no
Prefer hosting	select students trainees practicum athletes visitors all above	Physically Challenged	select the blind minor disability wheel chair access all above none of the above
Next tab bellow ê "Children" ê (Primary Host)

• Children
• Students
• House Pets

Children* (children in the household)
All fields(*)	when you have children	Required(*)	(**)Recommended
1st Child Name		Age	select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Gender	select female male
2nd Child Name		Age	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Gender	female male
3rd Child Name		Age	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Gender	female male
Next tab "Students" if you presently have any!  é

Students or Guests* (students who are presently in the household)
All fields(**)	if you have students	Required(*)	(**)Recommended
Student 1 Name		Occupying	select room 1 room 2 room 3
Gender	select female male	Age
Citizenship	country of origin Canada Germany Japan Saudi Arabia South Korea Switzerland U.K. U.S.A. ------------ Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Botswana Brazil British Virgin isl. Brunei Bulgaria Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Irak Iran Ireland Ireland, Northern Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Rwanda Saba Saipan Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Trinidad-Tobago Tunisia Turkey Turkmenistan United Arab Emirates U.S. Virgin Islands U.S.A. Uganda United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Yemen Zaire Zambia Zimbabwe
Leaving on
Student 2 Name		Occupying	room 1 room 2 room 3
Gender	female male	Age
Citizenship	Canada Germany Japan Saudi Arabia South Korea Switzerland U.K. U.S.A. ------------ Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Botswana Brazil British Virgin isl. Brunei Bulgaria Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Irak Iran Ireland Ireland, Northern Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Rwanda Saba Saipan Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Trinidad-Tobago Tunisia Turkey Turkmenistan United Arab Emirates U.S. Virgin Islands U.S.A. Uganda United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Yemen Zaire Zambia Zimbabwe
Leaving on
Student 3 Name		Occupying	room 1 room 2 room 3
Gender	female male	Age
Citizenship	Canada Germany Japan Saudi Arabia South Korea Switzerland U.K. U.S.A. ------------ Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Barbuda Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire Botswana Brazil British Virgin isl. Brunei Bulgaria Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Rep. Chad Channel Islands Chile China Colombia Congo Cook Islands Costa Rica Croatia Curacao Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Irak Iran Ireland Ireland, Northern Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kuwait Kyrgyzstan Latvia Lebanon Liberia Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Norway Oman Palau Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Rwanda Saba Saipan Saudi Arabia Scotland Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tanzania Thailand Togo Trinidad-Tobago Tunisia Turkey Turkmenistan United Arab Emirates U.S. Virgin Islands U.S.A. Uganda United Kingdom Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Wales Yemen Zaire Zambia Zimbabwe </>
Leaving on
Next tab "Pets" é if you have any!

Pets* (pets in the household)
All fields(*)	if you have pets	Required(*)	(**)Recommended
Pet 1 - Name		Pet Type	dog cat bird rabbit hamster fish reptile other
Breed		Other Type
Pet 2 - Name		Pet Type	dog cat bird rabbit hamster fish reptile other
Breed		Other
Pet 3 - Name		Pet Type	dog cat bird rabbit hamster fish reptile other
Breed		Other Type
Next tab bellow ê "Guestroom one" ê

• Guestroom one
• Guestroom two
• Guestroom three

Guestroom One: (description of guestrooms at your home and in-room amenities)
All fields(*)		Required(*)	(**)Recommended
Room Reference	Room 1
Available from
Available to
Room Status	select vacant ready vacant not ready soon vacant occupied
Room Location	select third floor second floor first floor main level ground level ground level suite basement suite in a condo in an apartment other	Size in feet	select smaller 90 100 110 120 130 140 150 160 170 180 190 200 larger
Opening Window	select yes no	Locking door	select yes no
Hydro/Electricity	select included excluded	Heat & hot water	select included excluded
Furnished	select yes no	Bed type	select standard bed sofabed hidabed futton water bed airbed raised airbed mattress only other
Bed size	select single twin double queen king sultan	2nd bed (if any)	select none single twin double queen
Closet/Wardrobe	select yes no	Desk with a chair	select yes no
Bedside table	select yes no	Dresser	select yes no
Mirror	select yes no	Clock & radio	select yes no
TV and Cable	select in-room shared	Internet Access	select wireless high-speed cable high-speed DSL shared location dail-up
Bathroom	select shared private ensuite	Bathroom Type	select full bath with shower
Living room	select shared private	Kitchen	select shared private
Separate Entrance	select yes no	Laundry	select shared coin operated nearby not available
Included Meals	select **three meals **brkfst and dinner breakfast and lunch lunch and dinner dinner lunch breakfast no meals	Expected Rate$	select 300 325 350 375 400 425 $450 475 500 525 550 575 600 625 650 675 700 725 750 775 800 825 850 875 900 925 950 975 1000 1025 1050 1075 1100 1125 1150 1175 1200
Room Description
Next tab "Guestroom two" if you have any! é

Guestroom Two: (description of guestrooms at your home and in-room amenities)
All fields(*)	if you have 2nd room	Required(*)	(**)Recommended
Room Reference	Room 2
Available from
Available to
Room Status	vacant ready vacant not ready soon vacant occupied
Room Location	third floor second floor first floor main level ground level ground level suite basement suite in a condo in an apartment other	Size in feet	smaller 90 100 110 120 130 140 150 160 170 180 190 200 larger
Opening Window	yes no	Locking door	yes no
Hydro/Electricity	included excluded	Heat & hot water	included excluded
Furnished	yes no	Bed type	standard bed sofabed hidabed futton water bed airbed raised airbed mattress only other
Bed size	single twin double queen king	2nd bed (if any)	none single twin double queen
Closet/Wardrobe	yes no	Desk with a chair	yes no
Bedside table	yes no	Dresser	yes no
Mirror	yes no	Clock & radio	yes no
TV and Cable	in-room shared	Internet Access	wireless high-speed cable high-speed DSL shared location dail-up
Bathroom	shared private ensuite	Bathroom Type	full bath with shower
Living room	shared private	Kitchen	shared private
Separate Entrance	yes no	Laundry	shared coin operated nearby not available
Included Meals	**three meals **brkfst and dinner breakfast and lunch lunch and dinner dinner lunch breakfast no meals	Expected Rate$	300 325 350 375 400 425 $450 475 500 525 550 575 600 625 650 675 700 725 750 775 800 825 850 875 900 925 950 975 1000 1025 1050 1075 1100 1125 1150 1175 1200
Room Description
Next tab "Guestroom three" if you have any! é

Guestroom Three: (description of guestrooms at your home and in-room amenities)
All fields(*)	if you have 3rd room	Required(*)	(**)Recommended
Room Reference	Room 3
Available from
Available to
Room Status	vacant ready vacant not ready soon vacant occupied
Room Location	third floor second floor first floor main level ground level ground level suite basement suite in a condo in an apartment other	Size in feet	smaller 90 100 110 120 130 140 150 160 170 180 190 200 larger
Opening Window	yes no	Locking door	yes no
Hydro/Electricity	included excluded	Heat & hot water	included excluded
Furnished	yes no	Bed type	standard bed sofabed hidabed futton water bed airbed raised airbed mattress only other
Bed size	single twin double queen king	2nd bed (if any)	none single twin double queen
Closet/Wardrobe	yes no	Desk with a chair	yes no
Bedside table	yes no	Dresser	yes no
Mirror	yes no	Clock & radio	yes no
TV and Cable	in-room shared	Internet Access	wireless high-speed cable high-speed DSL shared location dail-up
Bathroom	shared private ensuite	Bathroom Type	full bath with shower
Living room	shared private	Kitchen	shared private
Separate Entrance	yes no	Laundry	shared coin operated nearby not available
Included Meals	**three meals **brkfst and dinner breakfast and lunch lunch and dinner dinner lunch breakfast no meals	Expected Rate$	300 325 350 375 400 425 $450 475 500 525 550 575 600 625 650 675 700 725 750 775 800 825 850 875 900 925 950 975 1000 1025 1050 1075 1100 1125 1150 1175 1200
Room Description
Next tab bellow ê "Photograph"  ê

• Photographs
• Location
• Comments
• References
• Submit