Homestay Application Form

HOMESTAY APPLICATION FORM
STUDENT INFORMATION
Student's Full Name

Legal Last NameLegal First NamePreferred Name
Gender
Date of Birth

MonthDayYear
E-mail
example@example.com
Phone Number

Country CodeArea CodePhone Number
First Language
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
HOMESTAY REQUEST
Period of Homestay Requested

MonthDayYear
FROM
MonthDayYear
TO
Do you need airport pick up?
Arrival Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Flight Number
Please provide the following information for us to find the best match of host family for you:
Do you want to live with pets?
Do you want to live with young children?
Are there any food you cannot eat?
If yes, please specify
Do you have any medical problems?
If yes, please specify
Do you have any allergies?
If yes, please specify
What are your hobbies and interests?
Additional Requests & Comments
Application & Payment Information
- Complete this homestay application form and submit it to Canada Star Secondary School with the required payment. Applications will be processed after payments are received by the school.
- All homestay applicants must pay for the Homestay Application fee of CDN$300.00. This fee is non-refundable. Please use the following information for payment:
  - Email transfer: payment@canadastarsecondary.ca
  - Bank Transfer:
    
    Name of Bank: Bank of Montreal
    
    Bank Address: 3880 No3 Road #100, Richmond, BC Canada V6X 2C1
    
    Name of Account: Canada Star Education Group Inc
    
    Bank Number: 001
    
    Transit Number: 38770
    
    Account Number: 1983-357
    
    Swift Code: BOFMCAM2
    
    CC Code: CC000138770
    
    Bank Service Fee of $30.00 is Manually added to ALL Wire Transactions.
  - Should you have any questions, please do not hesitate to contact us at 604-285-7766.
- A student needs to request the homestay service at least one (1) month before the intended first day with the host family. The student will be responsible for arranging their own accomodation if the student fails to make the request within the period.
Please check the box below for the fees you need to pay (Rates below are subject to change without prior notice):
Upload Proof of Payment

Cancelof
Please Note:
- Students must provide both the homestay family and the Homestay Coordinators with one full month (30 days) written notice if they wish to leave either the homestay family or the program. If the required 30-day notice is not given, the deposit will be forfeited.
- Homestay families receive monthly payments. In the event that a student moves in on a day other than the beginning of the month, the payment will be adjusted as per below:
  1. If a student stays for 15 days or fewer during their first month, the rate will be $70/day.
  2. For stays of more than 15 days, the full monthly rate will apply.
- By signing below, you acknowledge your agreement to all the statements written on this application form and you also confirmed that you read the handbook and agree to abide by the policies and guidelines outlined wihtin as a condition during your stay in the host family under the Canada Star Secondary Homestay Program. I understand if I have question regarding homestay program policies, I will consult with the homestay coordinator.
Student Signature
Parent Signature
Date Signed

MonthDayYear
Date
Should be Empty:

HOMESTAY APPLICATION FORM

STUDENT INFORMATION

HOMESTAY REQUEST

Please provide the following information for us to find the best match of host family for you:

Application & Payment Information