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8
12%
First Name
(Required)
Last Name
Address
(Required)
City
(Required)
State / Province
(Required)
Postal / Zip Code
(Required)
Country
(Required)
Select a country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
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Bouvet Island
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Burkina Faso
Burundi
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Cameroon
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Chile
China
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Congo, Republic of the
Cook Islands
Costa Rica
Croatia
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Cyprus
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Djibouti
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Dominican Republic
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Virgin Islands, U.S.
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Phone number
(Required)
Cell number
E-mail
Hidden
What language do you speak at home?
English
French
Both
Other
What language do you speak at home?
English
French
Both
Other
Hidden
Which language would you be comfortable speaking with the student(s)?
English
French
Both
Other
Which language would you be comfortable speaking with the student(s)?
English
French
Both
Other
Wich other language(s)do you speak?
Occupation
Number of members of the family living with you?
(Required)
Last name of Spouse
First name of Spouse
Occupation
How did you learn about this program?
(Required)
Why would you like to become a homestay family?
(Required)
Hidden
Are you willing to have a police record check done?
(Required)
Yes
No
Are you willing to have a police record check done?
(Required)
Yes
No
Hidden
Have you hosted international students before?
(Required)
Yes
No
Have you hosted international students before?
(Required)
Yes
No
Hidden
Where would you like to host students from?
(Required)
North America
South America
Latin America
Middle East
Asia
Europe
Canada
Other
Where would you like to host students from?
(Required)
North America
South America
Latin America
Middle East
Asia
Europe
Canada
Other
Hidden
How long would you prefer the students to stay?
(Required)
1-4 weeks
2-3 months
3-6 months
6 months +
How long would you prefer the students to stay?
(Required)
1-4 weeks
2-3 months
3-6 months
6 months +
Hidden
When are you available to host students?
(Required)
Spring
Summer
Fall
Winter
All year around
When are you available to host students?
(Required)
Spring
Summer
Fall
Winter
All year around
How many students would you like to accommodate?
(Required)
Hidden
Would you prefer to host a male or female student?
(Required)
Male
Female
Either
UntitledWould you prefer to host a male or female student?
(Required)
Male
Female
Either
Hidden
What age range would you prefer to host?
(Required)
10-15
16-18
19-30
31-50
51+
What age range would you prefer to host?
(Required)
10-15
16-18
19-30
31-50
51+
In your home, will students have access to:
(Required)
washer and dryer
Shared bathroom
Private bathroom
Easy access to public transportation
3 meals per day (noon is a box lunch)
2 meals per day (breakfast and dinner)
1 meal per day (breakfast)
No meals per day
Acces to the kitchen if desired
Access to a computer
Access to wired internet
Access to wireless internet
Other information
Do you or any other occupants in your home smoke?
(Required)
Yes
No
Do you permit smoking in your home?
(Required)
Yes
No
Do you have working smoke detectors on each floor?
(Required)
Yes
No
Do you have any dogs?
(Required)
Yes
No
Do you have any cats?
(Required)
Yes
No
If you have children living at home, what are their names, and when were they born? month and year
If you have pets, how many and what kind?
What family activities would you involve the student (s) in?
(Required)
What are your family guidelines about the drinking of alcohol?
(Required)
What are your family guidelines about the use of the phone?
(Required)
Describe your home. Number of bedrooms, bathrooms, etc
(Required)
Describe the room(s) you have available for the student(s). Type of furniture , size of bed, etc
(Required)
Other comments
Upload a pictures of your house (maximum 10)
(Required)
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Select files
Max. file size: 256 MB, Max. files: 10.
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Montreal
Suite 400, 70 Rue Notre Dame Ouest
514 842 3847
Quebec
201 Grande Allée E
418 692 1370
Monday - Friday: 8:30 AM - 5 PM
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