International Homestay Application - Vernon Christian School

Applicant's Name*

First Last

Employer

Spouse's Name*

First Last

Employer

Address*

Street Address Address Line 2 City Province Postal Code

Phone*

Email*

List the people who live in your home

Family members, tenants, billets, other homestay students

Have you ever hosted an international student before?

From which country?

For how long?

Why are you interested in hosting an international student?*

Briefly describe your home*

Number of bedrooms, bathrooms, social areas, levels, neighbourhood, etc.

Describe the room where the student will sleep*

Location, furnishings, size

Does anyone in your household smoke?*

Do you have pets?*

Check all

What are your family’s rules about the use of the telephone, television and internet?

What are your family’s hobbies and interests?

What kinds of activities would you do that would include the student?

What kind of assistance are you prepared to give to your student with school assignments?

Please write anything else that you feel is important for the student to know about your household.

Food, laundry, family rules, etc.

What is the work schedule of family members? Who will be at home during the day when the student is at home? After school and weekends?

Please list two references (non-relatives) that we can contact.

First Last

Phone

Occupation

Relationship

Name

First Last

Phone

Occupation

Relationship

All permanent household members 19 years and older agree to undergo a Criminal Record Check*

Please include a picture of your family, the bedroom to be used by the student, and the front of your house.

These pictures will be shared with the student’s family once a student has been assigned to you.