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.

• Household
• Preferences
• Address

Household (Number of occupants, accommodations, spoken languages, etc...)
		Required(*)		(**)Recommended
Application Date
Type of home	selecthousetown housetown homeapartmentcondoranchfarm	Home Condition		selectnewrenovatedfairly newnewly renovatedNeeds renovations
Adults	selectonetwothreefour	Children		selectonetwothreefourfivenone
Students	selectonetwothreefourfivenone	Pets		selectonetwothreefourfivenone
Guestrooms	selectonetwothreefourfivenone
Guest suites	selectOne bedroom suiteTwo bedroom suiteThree bedroom suite
First Language	selectEnglishFrench--------ArabicBulgarianCatalanChinese (S)Chinese (T)CroatianCzechDanishDutchEnglishEstonianFinnishFrenchGermanGreekHebrewHungarianIcelandicItalianIndonesianJapaneseKoreanLatvianLithuanianNorwegianPersianPolishPortugueseRomanianRussianSerbianSlovakSlovenianSpanishSwedishTurkish	2nd language		selectEnglishFrenchNone--------ArabicBulgarianCatalanChinese (S)Chinese (T)CroatianCzechDanishDutchEnglishEstonianFinnishFrenchGermanGreekHebrewHungarianIcelandicItalianIndonesianJapaneseKoreanLatvianLithuanianNorwegianPersianPolishPortugueseRomanianRussianSerbianSlovakSlovenianSpanishSwedishTurkish
Any Smokers!	selectyes, smoke outsideyesno	Family Health		selectexcellentgoodsome challengessome concern
Activities			Hosted before!	selectyesno
& hobbies			Smoke detector	selectyesno

Hosting Preferences (why do you wish to host or who do you prefer to host)
			Required(*)			(**)Recommended
Why would you like to host students or house guests?
Prefer hosting		selectmalesfemalesboth	Meals preference			select**three meals**bkfast and dinnerbreakfast and lunchlunch and dinnerdinnerlunchbreakfastno meals
Ages 12  to 18 yrs.		selectyesno	Ages 19 and older			selectyesno
Accept couples		selectyesno	We accept smokers			selectyes, smoke outyesno
Prefer hosting		selectstudentstraineespracticumathletesvisitorsall above	Physically Challenged			selectthe blindminor disabilitywheel chair accessall abovenone of the above

Home Address & Contact Details*
		Required(*)	(**)Recommended
Street Address
City		State/Province
Country	select countryCanadaU.S.A.U.K.------------AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntiguaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBarbudaBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBotswanaBrazilBritish Virgin isl.BruneiBulgariaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African Rep.ChadChannel IslandsChileChinaColombiaCongoCook IslandsCosta RicaCroatiaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaeroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreat BritainGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIrakIranIrelandIreland, NorthernIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKuwaitKyrgyzstanLatviaLebanonLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmar/BurmaNamibiaNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorwayOmanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRwandaSabaSaipanSaudi ArabiaScotlandSenegalSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTanzaniaThailandTogoTrinidad-TobagoTunisiaTurkeyTurkmenistanUnited Arab EmiratesU.S. Virgin IslandsU.S.A.UgandaUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZaireZambiaZimbabwe	Postal Code
Email		Home Tel.
Cellular		Work Tel.

• Host one
• Host two
• Host three
• Children
• Students
• House Pets

Primary Host*
			(* ) Required			(**) Recommended
First Name			Last Name
Occupation			Gender			selectfemalemale
Age Group		select21-2526-3031-3536-4041-4546-5051-5556-6061-6566-7071-7576-8081+	Marital Status			selectmarriedcom. lawsingle
Do you drive?		selectyesno	Driver Licence

Second Host* (adults only who shares household duties)
			Required(*)			(**)Recommended
First Name			Last Name
Occupation			Relationship			selecthusbandwifeboy friendgirl friendbrotherdaughtersonsistermotherfathercousinniecegrand fathergrand mother
Age Group		select21-2526-3031-3536-4041-4546-5051-5556-6061-6566-7071-7576-8081+	Cellular

Additional Host* (additional adult only who lives in the household, if any)
			Required(*)			(**)Recommended
First Name			Last Name
Occupation			Relationship			selectdaughtersonbrothersistermotherfathercousinniecegrand fathergrand motherfriendson in lawdaugher in lawother
Age Group		select21-2526-3031-3536-4041-4546-5051-5556-6061-6566-7071-7576-8081+	Cellular

Children* (children in the household)
			Required(*)			(**)Recommended
1st Child Name			Age			select1234567891011121314151617181920
Gender		selectfemalemale
2nd Child Name			Age			select1234567891011121314151617181920
Gender		selectfemalemale
3rd Child Name			Age			select1234567891011121314151617181920
Gender		selectfemalemale

Students or Guests* (students who are presently in the household)
		Required(*)	(**)Recommended
Student 1 Name		Occupying	selectroom 1room 2room 3
Gender	selectfemalemale	Age
Citizenship	country of originCanadaGermanyJapanSaudi ArabiaSouth KoreaSwitzerlandU.K.U.S.A.------------AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntiguaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBarbudaBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBotswanaBrazilBritish Virgin isl.BruneiBulgariaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African Rep.ChadChannel IslandsChileChinaColombiaCongoCook IslandsCosta RicaCroatiaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaeroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreat BritainGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIrakIranIrelandIreland, NorthernIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKuwaitKyrgyzstanLatviaLebanonLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmar/BurmaNamibiaNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorwayOmanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRwandaSabaSaipanSaudi ArabiaScotlandSenegalSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTanzaniaThailandTogoTrinidad-TobagoTunisiaTurkeyTurkmenistanUnited Arab EmiratesU.S. Virgin IslandsU.S.A.UgandaUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZaireZambiaZimbabwe
Leaving on
Student 2 Name		Occupying	selectroom 1room 2room 3
Gender	selectfemalemale	Age
Citizenship	country of originCanadaGermanyJapanSaudi ArabiaSouth KoreaSwitzerlandU.K.U.S.A.------------AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntiguaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBarbudaBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBotswanaBrazilBritish Virgin isl.BruneiBulgariaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African Rep.ChadChannel IslandsChileChinaColombiaCongoCook IslandsCosta RicaCroatiaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaeroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreat BritainGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIrakIranIrelandIreland, NorthernIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKuwaitKyrgyzstanLatviaLebanonLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmar/BurmaNamibiaNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorwayOmanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRwandaSabaSaipanSaudi ArabiaScotlandSenegalSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTanzaniaThailandTogoTrinidad-TobagoTunisiaTurkeyTurkmenistanUnited Arab EmiratesU.S. Virgin IslandsU.S.A.UgandaUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZaireZambiaZimbabwe
Leaving on
Student 3 Name		Occupying	selectroom 1room 2room 3
Gender	selectfemalemale	Age
Citizenship	country of originCanadaGermanyJapanSaudi ArabiaSouth KoreaSwitzerlandU.K.U.S.A.------------AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntiguaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBarbudaBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBotswanaBrazilBritish Virgin isl.BruneiBulgariaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African Rep.ChadChannel IslandsChileChinaColombiaCongoCook IslandsCosta RicaCroatiaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaeroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreat BritainGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIrakIranIrelandIreland, NorthernIsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKuwaitKyrgyzstanLatviaLebanonLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmar/BurmaNamibiaNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNorwayOmanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRwandaSabaSaipanSaudi ArabiaScotlandSenegalSeychellesSierra LeoneSingaporeSlovak RepublicSloveniaSouth AfricaSouth KoreaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTanzaniaThailandTogoTrinidad-TobagoTunisiaTurkeyTurkmenistanUnited Arab EmiratesU.S. Virgin IslandsU.S.A.UgandaUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZaireZambiaZimbabwe
Leaving on

Pets* (pets in the household)
			Required(*)			(**)Recommended
Pet 1 - Name			Type			selectdogcatbirdrabbithamsterfishreptileother
Breed			Other Type
Pet 2 - Name			Type Type			selectdogcatbirdrabbithamsterfishreptileother
Breed			Other
Pet 3 - Name			Type			selectdogcatbirdrabbithamsterfishreptileother
Breed			Other Type

• Guestroom one
• Guestroom two
• Guestroom three

Guestroom One: (description of guestrooms at your home and in-room amenities)
		Required(*)	(**)Recommended
Room Reference	Room 1
Available from
Available to
Room Status	selectvacant readyvacant not readysoon vacantoccupied
Room Location	selectthird floorsecond floorfirst floormain levelground levelground level suitebasement suitein a condoin an apartmentother	Size in feet	selectsmaller90100110120130140150160170180190200larger
Opening Window	selectyesno	Locking door	selectyesno
Hydro/Electricity	selectincludedexcluded	Heat & hot water	selectincludedexcluded
Furnished	selectyesno	Bed type	selectstandard bedsofabedhidabedfuttonwater bedairbedraised airbedmattress onlyother
Bed size	selectsingletwindoublequeenkingsultan	2nd bed (if any)	selectnonesingletwindoublequeen
Closet/Wardrobe	selectyesno	Desk with a chair	selectyesno
Bedside table	selectyesno	Dresser	selectyesno
Mirror	selectyesno	Clock & radio	selectyesno
TV and Cable	selectin-roomshared	Internet Access	selectwirelesshigh-speed cablehigh-speed DSLshared locationdail-up
Bathroom	selectsharedprivateensuite	Bathroom Type	selectfull bathwith shower
Living room	selectsharedprivate	Kitchen	selectsharedprivate
Separate Entrance	selectyesno	Laundry	selectsharedcoin operatednearbynot available
Included Meals	select**three meals**brkfst and dinnerbreakfast and lunchlunch and dinnerdinnerlunchbreakfastno meals	Expected Rate$	select300325350375400425$450475500525550575600625650675700725750775800825850875900925950975100010251050107511001125115011751200
Room Remarks

Guestroom Two: (description of guestrooms at your home and in-room amenities)
		Required(*)	(**)Recommended
Room Reference	Room 2
Available from
Available to
Room Status	selectvacant readyvacant not readysoon vacantoccupied
Room Location	selectthird floorsecond floorfirst floormain levelground levelground level suitebasement suitein a condoin an apartmentother	Size in feet	selectsmaller90100110120130140150160170180190200larger
Opening Window	selectyesno	Locking door	selectyesno
Hydro/Electricity	selectincludedexcluded	Heat & hot water	selectincludedexcluded
Furnished	selectyesno	Bed type	selectstandard bedsofabedhidabedfuttonwater bedairbedraised airbedmattress onlyother
Bed size	selectsingletwindoublequeenking	2nd bed (if any)	selectnonesingletwindoublequeen
Closet/Wardrobe	selectyesno	Desk with a chair	selectyesno
Bedside table	selectyesno	Dresser	selectyesno
Mirror	selectyesno	Clock & radio	selectyesno
TV and Cable	selectin-roomshared	Internet Access	selectwirelesshigh-speed cablehigh-speed DSLshared locationdail-up
Bathroom	selectsharedprivateensuite	Bathroom Type	selectfull bathwith shower
Living room	selectsharedprivate	Kitchen	selectsharedprivate
Separate Entrance	selectyesno	Laundry	selectsharedcoin operatednearbynot available
Included Meals	select**three meals**brkfst and dinnerbreakfast and lunchlunch and dinnerdinnerlunchbreakfastno meals	Expected Rate$	select300325350375400425$450475500525550575600625650675700725750775800825850875900925950975100010251050107511001125115011751200
Room Remarks

Guestroom Three: (description of guestrooms at your home and in-room amenities)
		Required(*)	(**)Recommended
Room Reference	Room 3
Available from
Available to
Room Status	selectvacant readyvacant not readysoon vacantoccupied
Room Location	selectthird floorsecond floorfirst floormain levelground levelground level suitebasement suitein a condoin an apartmentother	Size in feet	selectsmaller90100110120130140150160170180190200larger
Opening Window	selectyesno	Locking door	selectyesno
Hydro/Electricity	selectincludedexcluded	Heat & hot water	selectincludedexcluded
Furnished	selectyesno	Bed type	selectstandard bedsofabedhidabedfuttonwater bedairbedraised airbedmattress onlyother
Bed size	selectsingletwindoublequeenking	2nd bed (if any)	selectnonesingletwindoublequeen
Closet/Wardrobe	selectyesno	Desk with a chair	selectyesno
Bedside table	selectyesno	Dresser	selectyesno
Mirror	selectyesno	Clock & radio	selectyesno
TV and Cable	selectin-roomshared	Internet Access	selectwirelesshigh-speed cablehigh-speed DSLshared locationdail-up
Bathroom	selectsharedprivateensuite	Bathroom Type	selectfull bathwith shower
Living room	selectsharedprivate	Kitchen	selectsharedprivate
Separate Entrance	selectyesno	Laundry	selectsharedcoin operatednearbynot available
Included Meals	select**three meals**brkfst and dinnerbreakfast and lunchlunch and dinnerdinnerlunchbreakfastno meals	Expected Rate$	select300325350375400425$450475500525550575600625650675700725750775800825850875900925950975100010251050107511001125115011751200
Room Remarks

• Photographs
• Location
• Comments
• References
• Submit