Homestay Host Family Application

Please complete the form provided to begin the process of matching you with a suitable homestay.

Family Information

Family Nationality

First Language / Second Language

Family Member #1 (Name/Relationship/Birth Year/Occupation)

Family Member #2 (Name/Relationship/Birth Year/Occupation)

Family Member #3 (Name/Relationship/Birth Year/Occupation)

Family Member #4 (Name/Relationship/Birth Year/Occupation)

Certification and Autuorization for Release of Information

I certify that all of the information above is to the best of my knowledge and belief true, correct and complete. I understand this information will be used to determine my eligibility for homestay host application. I further authorize disclosure of my homestay information to the homestay programs and its commercial use.

Your Signature

Date