HOST APPLICATION

HOST APPLICATION
PERSONAL INFORMATION
Name

FIRST NAMELAST NAME
MAILING ADDRESS
EMAIL
ENTER YOUR EMAIL
PHONE #
CELL #
NEAREST INTERSECTION
FAMILY INFORMATION

PLEASE LIST EACH FAMILY MEMBER INCLUDING YOUR SPOUSE AND SELF

	FIRST NAME	AGE	OCCUPATION	RELATION

PLACE OF EMPLOYMENT
HOME INFORMATION
PLEASE LIST YOUR PETS
IF OTHER, PLEASE SPECIFY
ARE THERE SMOKERS IN THE HOUSE
CLOSEST TRANSIT STATION
DISTANCE TO BUS STOP
APROX DISTANCE
OTHER INFORMATION
PLEASE LIST THE HOBBIES, ACTIVITIES OR INTERESTS THAT YOUR FAMILY WILL BE WILLING TO SHARE WITH THE STUDENTS
PLEASE GIVE A GENERAL DESCRIPTION BELOW OF THE TYPE OF FOOD A STUDENT CAN EXPECT FOR EACH MEAL. FOR EXAMPLE, BREAKFAST - PANCAKES, TOAST WITH JAMS, EGGS; LUNCH - SANDWICH, FRUITS ETC
CURRENT STATUS IN CANANDA
IF OTHER, PLEASE SPECIFY
IF YOU ARE NOT BORN IN CANADA, PLEASE SPECIFY HOW LONG YOU HAVE LIVED HERE?
WRITE THE AMOUNT OF YEARS
IN ADDITION TO ENGLISH, WHAT OTHER LANGUAGES ARE SPOKEN IN YOUR HOUSEHOLD?
HOW LONG HAVE YOU BEEN PROVIDING HOMESTAY?
OTHER INFORMATION CONT'.........
WILL YOU PARTICIPATE IN POLICE BACKGROUND CHECK, IF REQUIRED?
WILL YOU PARTICIPATE IN POLICE BACKGROUND CHECK, IF REQUIRED?
DO YOU PREFER MALE OR FEMALE STUDENT(S)?:

FEMALEMALENON RELEVANT
HOW MANY ROOMS ARE AVAILABLE TO HOST STUDENT(S)?
DO YOU HAVE PRIVATE BATHROOMS FOR STUDENT(S)?
IF NOT, HOW MANY PEOPLE SHARE A BATHROOM?
AT WHICH LEVEL(S) OF THE HOUSE ARE THE STUDENT ROOMS LOCATED?
PLEASE LIST ALL THAT IS PROVIDED IN THE STUDENT'S ROOM

DRAWERSCLOSETCHAIRDESKLAMPT VINTERNET
PLEASE USE THE SPACE BELOW TO TELL US WHY YOU ARE INTERESTED IN HOSTING INTERNATIONAL STUDENT(S) AND ANY EXTRA INFORMATION YOU WOULD LIKE US TO INCLUDE IN YOUR FILE
By submitting/signing the form, you understand that the stated information provided is correct and if any changes occur, you will inform C & M Homestay Agency™ promptly. When placed with a student, you will provide a clean, furnished, private room, a warm and hospitable environment, agreed upon board. You have also read and fully accept all C&M Homestay's Terms and Condition outlined in the C & M Homestay Agency Agreement. C & M Homestay Agency™ DO NOT assume responsibility for any damage or loss in any form.
PLEASE PRINT YOUR NAME
DATE

MesDíaAño
Fecha
565 Bloor St W, Toronto, Ontario M5S 1Y6, Canada
mail@cmhomestayagency.com

housing@cmhomestayagency.com

www.cmhomestayagency.com
Should be Empty:

HOST APPLICATION

PERSONAL INFORMATION

FAMILY INFORMATION

HOME INFORMATION

OTHER INFORMATION

OTHER INFORMATION CONT'.........

565 Bloor St W, Toronto, Ontario M5S 1Y6, Canada