Homestay Application

Applications must be received by Vancouver Premier College a minimum of 30 days prior to your first night.
Mr. Ms.
Family Name:*  First Name:*
Other Name:  Birth Date:dd/mm/yy

Mailing Address:
*
City:*  State/Province:*
ZIP/Postal Code:*  Country:*
Telephone:* *  Fax: 
E-Mail:*
Nationality:*  First Language:*

Citizenship Status: Canadian   Landed Immigrant   International Student 
If landed immigrant then please state country of origin:

First night of your homestay: dd/mm/yy

If you are going to stay shorter then one month:
Last night of your homestay: dd/mm/yy

Do you need to be picked up when you arrive at Vancouver International Airport?
Yes (Airport Pickup Fee is $65.00)   No

Your flight information: Airline/Flight #:
Arrival Date & Time:

Medical Information:
Do you have any allergies or medical conditions that Vancouver Premier College should know about in the event of an emergency?
Yes   No  If yes, please specify:

Please list your interests or hobbies (music, sports, etc.):

Do you smoke?: Yes   No  If yes, you may be required to smoke outside.
Are you?: (Choose all that apply)
  Energetic   Quiet   Sociable   Outgoing   Calm   Reserved

Do you?: Like to spend a lot of quiet time at home   Enjoy a busy social life

Is there any other information you would like to tell us?:

Homestay Cancellation Policy

If you wish to change or cancel your homestay, you are required to give 30 days notice to both Canadian Vancouver International Homestay Ltd. and your host family. Please note the following details regarding canceling or changing your Homestay:

  1. Unable to enter Canada due to visa difficulties:
    Full refund of the paid first month homestay fee, no refund of the placement fee unless the placement has not been processed.
  2. Canceling with less than 30 days notice prior to arrival:
    Full refund of the paid first month homestay fee, no refund of the placement fee.
  3. Canceling with less than 14 days notice prior to arrival:
    50% refund of homestay fee and no refund of placement fee.
  4. If the student have requested airport pick up and does not cancel before the pick up date:
    100% of the airport pick up fee will be charged.

I understand that the homestay company will select a family from those available, based on the information that I have provided and that they cannot guarantee that all of my personal preferences will be met. I have also read and understood the homestay cancellation policy. I know my charge card will be billed the $195.00 placement fee, and $65.00 airport reception fee (if applicable). By submitting this form, I am agreeing to all of the above.

* Required


Â