Application to have a Homestay at Vancouver Happy Homestay
Please click on the Submit button to submit the form details.
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indicates required fields
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First Name:
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Last Name:
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Sex:
Male
Female
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Birth Date (yyyy/mm/dd):
Address:
City:
State/Province:
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Country:
ZIP/Postal Code:
Nationality:
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Telephone number:
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Enter your email address:
Emergency contact: Name/telephone/email:
I will attend school:
yes
no
School Name:
School Address:
What will you study:
English
other
How many weeks will you study for:
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Enter the date you will want your homestay for:
Do you have any allergies:
yes
no
If (yes) please describe:
Do you have special medical needs:
yes
no
If (yes) please describe:
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Do you smoke:
yes
no
List some of your interests or hobbies:
Briefly describe your personality:
Is a homestay with pets ok:
yes
no
doesn't matter
Pick the Homestay program you would like:
Traditional Homestay 1 - deluxe1 with 3 meals
Traditional Homestay 1 - deluxe2 with 3 meals
Traditional Homestay 3 - (3 meals)
Traditional Homestay 4 - (2 meals)
Traditional Homestay 5 - (Breakfast)
Traditional Homestay 6 - (no meals)
Teacher Homestay 1 - ( 3 english lessons/week)
Teacher Homestay 2 - (15 english lessons/week)
Short Stay 1 - (Not during June, July, or August)
Short Stay 2 - (During June, July, or August)
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Do you have an arrival date/time:
yes
no
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Date of Arrival (yyyy/mm/dd):
Time of Arrival:
Name of Airline:
Arrival Flight #:
Do you have a departure date/time:
yes
no
Date of Departure (yyyy/mm/dd):
Time of Departure:
Name of Airline:
Departure Flight #:
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I require airport pickup (cost is $60):
yes
no
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I require airport drop off (cost is $35):
yes
no
Please add any comments or questions you have:
What website did you find us on:
What search Engine did you use:
Other
Yahoo
Google
MSN
Please click on the Submit button to submit the form details.
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