Student Registration Form

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Student Registration

Please use this for to register as a student seeking accomodation with Homestay Plus.

Step 1 of 5 - Personal Information

Personal Information
Please enter your accurate personal information in below boxes. All fields marked with (*) are required.
Your Name*
First Middle Name Last
Enter your full name .
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone Number*
Your home phone number.
Cell Number
If you use your cell number as your home phone number, please enter the same number here.
Your Email*
Enter Email Confirm Email

Enter your correct email address. This will be used as a primary source of contact.
Other Information
Occupation*
D.O.B*
DD slash MM slash YYYY

Your date of birth.
Sex*
Level of English*
Parent or Emergency Contact
Name*
Phone*
Relationship*

Special Instructions
Any special requests or instructions?*
Use the space below to provide any additional information about you that you think may be useful or may benefit and help us in selecting a proper Host Family for you. Enter NA if you do not wish to provide any other info.
Acknowledgement.
I understand that by filling in this registration form, I agree to, and will obey all the following conditions as a homestay student:

1. Before confirmed arrangements can be made with a Canadian host family, the placement and a minimum of the first 4 weeks homestay fees must be received in Canadian funds. The placement fee is non-refundable.

2. I agree to make prompt payments of all additional homestay fees.

3. I will participate in my host family’s daily activities, speak English whenever possible, and respect the host family’s home.

4. I will be responsible to keep my accommodation clean. At the end of my homestay I will leave the accommodation in the same condition that I found it and will accept responsibility for any damage, loss, or unpaid bills caused by myself or by my friends in the host family’s home.

5. I will not invite any friends or family members to the host family’s home, unless I have received permission from the host family first. I accept complete responsibility for the behavior and action of my guests, while they are in the host family’s home.

6. I agree not to smoke or drink alcohol in the host family’s home, unless invited.

7. I will inform my host family in advance if I am planning to be away for evening meals or if I will return later than expected.
8. I agree to stay with the host family until*
DD slash MM slash YYYY
8. If I decide to stay any extra days, or to leave earlier than the above mentioned date, I will give the host family 2 weeks’ notice. In lieu of notice students must pay 2 weeks of homestay fee.

9. Homestay Plus is not responsible for any loss or damage to your belongings while staying with our homestay family.
Agreement*
- I accept the above Terms of Agreement
Name*
First Last
Date*
DD slash MM slash YYYY
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Student Registration Form

Student Registration Form

Student Registration

Step 1 of 5 - Personal Information

Personal Information

Other Information

Parent or Emergency Contact

Homestay Information

Other info.

Medical Info.

Interests / Hobbies

Airport Pickup

School Details

Special Instructions

Acknowledgement.