Bowers Homestay and Educational Services of Canada

Homestay Family Application: 



Mr.      Mrs.
     Ms.

Family Name:

First Name:

Male     Female             DOB DD/MM//YYYY

Employment:

Spouse's Last Name:

Spouses First Name:

Male     Female             DOB DD/MM/YYYY

Employment:

Home Address, City, Province, Postal Code

Phone No:          Fax:

Email:     Web Page

Nearest N/S Street:      
Nearest E/W Street:   

Route to Downtown:
 

Family members:

      Name       /        Relationship       /      Date of Birth

 1.

 2.

 3.

 4.

Number of Dependents:   

Language(s) Spoken:  

Preferences:     
Gender:  Age:    Religion: 

Household Pets: 

Do you allow smoking in your home? 

Type of Home 

No. of rooms available        

Shared/Private Bath 

Parking

Describe how you will be able to interact with your host student:

Your Interests: 
Sports:

Music:

Hobbies:

Other:

TV Programs:

Favorite Foods

Have you hosted international students before? If yes please explain



How did you hear about us? 

Please list two personal references (Name, Relationship, Phone Numbers):



BY SUBMITTING THIS ONLINE FORM, I UNDERSTAND THAT WHEN PLACED WITH A STUDENT BY BOWERS HOMESTAY SERVICES (BHS), I AM A HOST FAMILY REPRESENTED BY BHS AND UNDER NO CIRCUMSTANCES WILL MY FAMILY HOST STUDENTS FOR SCHOOLS IN WHICH I HAVE RECEIVED STUDENTS FROM BHS THAT HAVE NOT BEEN PLACED BY BHS.

I WILL PROVIDE A CLEAN FURNISHED PRIVATE ROOM, WARM AND HOSPITABLE ENVIRONMENT AND THE AGREED UPON BOARD. I ALSO UNDERSTAND THAT BOWERS HOMESTAY SERVICES IS NOT LIABLE FOR ANY DAMAGES OR LOSS CAUSED BY THE STUDENT.

I also understand that I will be paid for the time the student occupies the room only.

Last Updated:  June 25, 2010 09:21 PM

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