Host Family Questionnaire

Thank you for your interest in becoming a Host Family. We will be delighted to work with you.

Please follow the next steps:

Fill out the online questionnaire.
Wait for us to contact you with further information about the Homestay Program.
We will contact you to schedule an appointment to visit your home.

WE ARE LOOKING FORWARD TO MEETING YOU!

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Family Name*

Given name*

Address

Street number and name*

City, Province*

Postal Code*

Contact information

Home phone*

Cell phone*

Other phone

Email address*

Occupation*

Date of Birth*

Other people living in the home

Do you live with one or more people?*

Yes

How many people live with you?

Family Member #1

Family Name*

Given Name*

Relationship to you*

Date of birth*

Occupation*

Phone Number

Email address

Family Member #2

Family Name*

Given Name*

Relationship to you*

Date of birth*

Occupation*

Phone Number

Email address

Family Member #3

Family Name*

Given Name*

Relationship to you*

Date of birth*

Occupation*

Phone Number

Email address

Family Member #4

Family Name*

Given Name*

Relationship to you*

Date of birth*

Occupation*

Phone Number

Email address

Emergency contact information

Please provide information about someone who is NOT living in your home, who we can contact in case of an emergency.

Full Name *

Cellphone number*

Relationship to you*

Host Family Questionnaire

Address

Contact information

Other people living in the home

Family Member #1

Family Member #2

Family Member #3

Family Member #4

Emergency contact information

Homestay information

Facilities for student use

Information about Students you would like to Host