Welcome to Toronto's best homestay services TORONTO HOMESTAY AGENCY
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   Student Services and Information - HOMESTAY APPLICATION
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Toronto Homestay Agency
Student Homestay Application

Please fill out the following application if you wish to book a Homestay, for inquiries and questions please use our contact page! (Click Here)
First Name:      
Last Name:      
Your e-mail 

Sex:

 Male Female      

Martial Status:

 Single Married Other  

Home Address                   

          

Street:

      

City/Town:

  Province/State:

 

Country:

  Postal/ZipCode:

 

Personal Information                  

          

Date of Birth:

mm/dd/yy   Country of Birth:

 

Fathers Name:

   Mothers Name:  

Parents Address                  

          

Street:

      

City/Town:

  Province/State:

 

Country:

  Postal/ZipCode:

 

Telephone 

  e-mail address:

Fax: 

Emergency Contact               

Name: 

  Telephone:

 

General Information           

      Knowledge of English language: Beginner    Medium    Fluent 

Nationality:

Interests:

   

Hobbies:

Career Interest:
   

What School are you attending?  

Name of School:

  

School Address
and City:

  
 
   

         Start Date of Classes:(mm/dd/yy)  

  
   

Do you have?

   Student Visa:   Visitor Visa:   Working Holiday:
   

Please indicate YES or NO:
Do you have Medical Insurance:    Yes            No  
Is a smoking home OK:   Yes            No
IF YES, are you willing to smoke outside
  Yes            No
Do you drink Alcohol?    Yes            No  
Do you like animals/pets?   Yes            No
Is a home with a pet OK?   Yes            No
Have you ever been abroad before?   Yes            No  
If so, where and how long?  
Do you have allergies?   Yes            No
If yes, please explain:
Do you have any physical disabilities?  Yes            No  
If yes, please explain:  
Do you require special medical treatment? Yes            No
If yes, please explain:
Do you need a special diet?  Yes            No  
If yes, please explain:  

Do you require:

  Three-Meal Plan:    Two Meal Plan:   Breakfast only:
  No Meals:
Please indicate that you require a Guardian Service while in Toronto:  
                                               Yes:             No:

Additional comments, questions, concerns: 
Please indicate what kind of family you would like to stay with?
 A Family with young children
 A Family with teenage children
 A Family without children
 I have no preference
Flight Information:      
Arrival date in Toronto:    mm/dd/yy 
Airline:  Flight#
Arrival time in Toronto:   
Do you require airport pickup?  Yes:             No:

Homestay period:    

From:   To:  

Payment method:            

 International Money Order
 Certified Cheque
 Bank Transfer
Once you have filled in all applicable details, please submit this form.  We will contact you on receipt with the information you require and details of payment.
By sending this application you acknowledge that you have read and understand the Students Responsibilities page.
   

Note: For proof of origin of this document your IP address and login will be recorded
  

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