Guest application

Application to have a Homestay at Vancouver Happy Homestay
Please click on the Submit button to submit the form details.

* indicates required fields

*First Name:

*Last Name:

*Sex:

Male
Female

*Birth Date (yyyy/mm/dd):

Address:

City:

State/Province:

*Country:

ZIP/Postal Code:

Nationality:

*Telephone number:

*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:

*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:

*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 2 - deluxe2 with 3 meals
Traditional Homestay 3 - (3 meals)
Traditional Homestay 4 - (2 meals)
Traditional Homestay 5 - (Breakfast)
Teacher Homestay 1 - ( 3 english lessons/week)
Teacher Homestay 2 - (15 english lessons/week)
Short Stay Plan 1 - September 1st to December 31st
Short Stay Plan 2 - January 1st to August 31st
Bed & Breakfast

*Do you have an arrival date/time:

yes
no

*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 #:

*I require airport pickup (cost is $60):

yes
no

*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

Web Promo Code 1:

Web Promo Code 2:

Web Promo Code 3:

Please click on the Submit button to submit the form details.

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