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Homestay location * (1)
Destination Country
*
Select
Australia
Canada
New Zealand
United Kingdom
United States
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos [Keeling] Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mariana Islands
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar [Burma]
Namibia
Nauru
Nepal
Netherlands
New Caledonia
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Republic of the Congo
Romania
Russia
Rwanda
S. Georgia & Sandwich Islds
São Tomé and PrÃncipe
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St Vincent & Grenadin
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Select the destination
country. It is the country
where you need homestay or
attend study.
Destination State / Province
*
Select
Select destination state/province
or province in order to select
the city name in next drop down
field. Country must be selected
first for this field to appear.
Destination City / Town
*
Select
Select the homestay destination
city or town from the list or
the closest town or suburb.
You must select country and state
before you could search the list
of city names in the area.
Other City
Include any other town(s)
in the proximity of your school
that can potentially be
another good nearby location.
If you are flexible with location,
city, or town, let us know here.
Homestay request * (2)
Start Date
*
01/18/2021
01
02
03
04
05
06
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11
12
Month
01
02
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30
31
day
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Year
Select start date that you wish to
start or move into a homestay.
Note: it must be at least three days
from today.
End Date
*
01/18/2021
01
02
03
04
05
06
07
08
09
10
11
12
Month
01
02
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30
31
day
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
Year
Select homestay end date that
you plan to move out from the
homestay.
Reason for visit
Study at School
Study at College
Study at University
Internship
Training
Holiday
Visit family
Leisure
Culture exchange
Work
Business
Other
In couple of words, tell us the
reason why you want to stay
in a homestay
Average Homestay Rates
Average monthly homestay rates
are based on all current data of
homestay pricing by city. It is
useful to determine your budget
or asking price.
Here is a link to help you research
the average monthly homestay rate
in order to be able to set your budget.
Search Average Rates
Preferred Meals
Breakfast and dinner
No meals
Breakfast only
Breakfast and dinner
Three meals
Breakfast and lunch
Lunch and dinner
Lunch or brunch only
Dinner or Supper only
Select meal plan that you
wish to get during your stay.
Note: Breakfast or lunch
meals are usually self-service.
$ Monthly Budget
The budget should be a
reasonable figure, so
the success of your
homestay placement will
depend on this figure.
If you are staying less
than a month. Your budget
will be prorated to daily
or weekly for a short stay.
1,000
Do you have a special diet?
Do you have any special diet?
i.e. veterinarian, no dairy,
don't eat fish, etc...
Do you have a special request?
No
No
Yes
Request like host ID number
or else
What is your special request?
Do you have any special request
for the homestay coordinator to keep
in mind when contacting hosts for you.
Example:
Or simply I like homestay be close to
public bus or transit system.
Referred by
Select
friend
classmate
colleague
neighbour
school
website
search engine
directory
classified ad
brochure
family
other
How did you learn about us?
Referral
Who referred you to us?
name person, site, school
or organization.
School or workplace * (3)
Will you commute to school or workplace?
We need to know if you will attend
school or college at the homestay
destination. This way, we can plan
to make your daily commute easier
if it is all possible.
Yes
Yes
No
School/Establishment
Name of school, college, university,
or work place that you will commute to
every day after you start your homestay.
Street address
City/Town
State/Province
Country
Postal Code
Zip or Postal code of you school
college, university, or work
Without state code please
Start Date
01/18/2021
01
02
03
04
05
06
07
08
09
10
11
12
Month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
day
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
Year
Homestay applicant* (4)
Applicant First Name
*
Family Name
*
Gender
*
Female
Male
Age
*
Required for host family to evaluate
the care and involvement needed
to host you.
Citizen of
*
Select
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos [Keeling] Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mariana Islands
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar [Burma]
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Republic of the Congo
Romania
Russia
Rwanda
S. Georgia & Sandwich Islds
São Tomé and PrÃncipe
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St Vincent & Grenadin
St Vincent & Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Are okay with pets?
pet friendly
Select
bird
cat
dog
fish
hamster
mouse
pet friendly
rabbit
Select no to pet type that you cannot
live with or tolerate for any reason.
Remember most hosts have pets so choose
carefully in order to find a suitable
homestay.
Do you smoke?
No Smoker
No Smoker
Smoke Outside
No smoking is allowed majority of
western homes and residences.
Some hosts offer designated outdoor
areas to smoke. Select smoke outside
if you need to smoke.
What is your English level?
Beginner
Beginner
Intermediate
Upper Intermediate
Advanced
Home Tongue
Tell us about your spoken English level.
i.e. Beginner, Intermediate, or Advanced
Do you have any allergies?
No
No
Yes
Like food allergies or else!
Caused by
Do you have any allergic condition
i.e. peanut allergy, cats' fur, fish, etc...
Any allergies that your hosts should
be aware of.
Do you have a health condition?
No
No
Yes
Health condition like diagnosed
physical or psychological
that host should be aware off
What is the Health Condition?
Do you have any health condition
that your host need to know about?
Your Hobbies
What are you hobbies?
Example: Soccer, Reading,
Movies, Games, ...
Applicant photo* (5)
Personal Photo *
Add student or guest photo to
introduce you to host families.
We ask host to reciprocate with
their photos too. Do NOT forget
to smile :-)
Select File...
Delete
Drag a file and drop it here
Contact person* (6)
Who is the contact person for the applicant?
*
Applicant
Relative
Friend
Agent
School
Other
Who are you?
First Name of Contact
Last Name
Company Name
Email
*
The coordinator and host family will
use your email to contact you.
Confirm Email
*
Type your email address
again to confirm your correct
email address. Please DO
NOT copy and paste for
better result.
Mobile Number
type your mobile number
including country code and
area code
Home Phone
type your home number including
country code and area code
Home address* (7)
Home Address
*
City / Town
*
type your city or town name
State / Province
*
type your state or province
Country
*
Select
Afghanistan
Aland
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos [Keeling] Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Mariana Islands
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar [Burma]
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Réunion
Republic of the Congo
Romania
Russia
Rwanda
S. Georgia & Sandwich Islds
São Tomé and PrÃncipe
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
South Sudan
Spain
Sri Lanka
St Vincent & Grenadin
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Minor Outlying Islands
U.S. Virgin Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Postal Code
your zip or postal code
Emergency contact
Emergency Contact
Some whom the agency or host family
can contact in case that you are hurt
or in need of help.
Relationship
Select
boyfriend
brother
classmate
cousin
daughter
father
friend
girlfriend
husband
mother
niece
other
schoolmate
sister
son
wife
Emergency Mobile
Sharing companion (8)
Companion / Roommate
No
No
Yes
Will you have anyone coming
to stay with you at the homestay?
Select Yes, if you want them to be
accommodated with you. If you
select No, leave this companion
fields blank or empty
Companion's Name
What is your companion's name?
Relationship
Select
husband
wife
boyfriend
girlfriend
brother
sister
daughter
son
father
mother
cousin
niece
classmate
schoolmate
other
friend
Who is stay with you?
Age
What is your companion's age?
Does roommate smoke?
No Smoker
No Smoker
Smoke Outside
For how long want to stay?
How long your companion wish to stay?
This will be subject to availability
Want to share
one room has two single beds
one room has one double bed
two rooms have two beds
two rooms have three beds
Will you companion share a
bed or a room with you?
Arrival date (9)
Arrival Date
01/18/2021
01
02
03
04
05
06
07
08
09
10
11
12
Month
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
day
2019
2020
2021
2022
2023
2024
2025
2026
Year
Arrival date to your destination city
if this information is available by now
You can always add this info later or
notify the your coordinator and your host
Arrival Time
Hour:Minutes
Time of arrival if you know by now.
You can add arrival information later.
Agreement* (10)
Disclaimer
We/I, (the applicant, participant, registrant, student, guest, agent, parent, guardian, and representative), understand and acknowledge all possible risks related to participating in a homestay program and staying in someone's home. We agree to hold harm the homestay agency (IHA/VHA) harmless including all its entities, directors, employees, agents, shareholders, partners, and subsidiaries from all liabilities, damages, injury, and loss claims.
Disclaimer
*
Yes
Yes
To proceed, you must mark this yes to
indicate that you read the disclaimer,
terms, and conditions.
01/18/2021
* Required field(s)
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