Application to become a Host Family

International students are interested in learning as much as possible about their new home before they arrive in Canada. Please provide as much detail as possible when completing this application form. Feel free to write extra comments in the comments section.

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Personal Information Full Name Address City Province Postal Code Home Phone  Enter a valid phone number. Example: 123-456-7890 Work Phone  Enter a valid phone number. Example: 123-456-7890 Work extension Cell Phone  Enter a valid phone number. Example: 123-456-7890 Email Address  Enter a valid email address. Example: name@company.com Homestay Information Have you been a homestay in previous years? No Yes Could you describe your living situation? SingleFamilyParentRetiredOther (Please describe below) Other: Do you smoke? No Yes Do you allow smoking in your home? No Yes Do you have Internet Access? No Yes What type of student would you prefer? MaleFemaleEither Number of Rooms Offered and Location (ie. 2nd level/basement) Type of Bathroom Shared Private Approximately how many minutes does it take to walk from the College to your home? If taking a Bus to the college, which routes are easily accessible from your home? 1 / 1A (King) 4 (Bayfront) 7 (Locke) 10 (Beeline Express) 21 (Upper Kenilworth) 24 (Upper Sherman) 27 (Upper James) 35 (College) 51 (University) 55A (Stoney Creek: Barton) 2 (Barton) 5 (Delaware) 8 (York) 11 (Parkdale) 22 (Upper Ottawa) 25 (Upper Wentworth) 33 (Sanitorium) 41 (Mohawk) 52A (Dundas Local) 58 (Stoney Creek: King) 3 (Cannon) 6 (Aberdeen) 9 (Rock Gardens) 16 (Ancaster) 23 (Upper Gage) 26 (Upper Wellington) 34 (Upper Paradise) 43 (Stone Church) 55 (Stoney Creek: HWY 8) Approximately how many minutes does it take to reach Mohawk by Bus? Do you have any pets? No Yes Name, type and age of pets: Additional Information 1. Please list the names of all persons who live in your home and the birthdates of all Children 2. Please indicate the nature of employment for all applicable family members 3. Please list any restrictions or concerns 4. What activities in and around your home could you invite the student to participate? 5. Briefly describe a normal daily routine in your home (For example: Student will help themselves to breakfast at a approx. 7AM, a bagged lunch will be provided, dinner will be with the family around 6 PM, etc...) 6. Please list any other questions or comments