Homestay location * (1)
Destination Country *
Select the destination
country. It is the country
where you need homestay or
attend study.
Destination State / Province *
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 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 *

Month
day
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 *

Month
day
Year
 
Select homestay end date that
you plan to move out from the
homestay.
Reason for visit
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
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.
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?
Request like host ID number
or else
Referred by
How did you learn about us?
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.
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

Month
day
Year
 
Homestay applicant* (4)
Applicant First Name *
Family Name *
Gender *
Age *
Required for host family to evaluate
the care and involvement needed
to host you.
Citizen of *
Are okay with pets?
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 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?
Tell us about your spoken English level.
i.e. Beginner, Intermediate, or Advanced
Do you have any allergies?
Like food allergies or else!
Do you have a health condition?
Health condition like diagnosed
physical or psychological
that host should be aware off
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...
Drag an image here
Contact person* (6)
Who is the contact person for the applicant? *
Who are you?
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 *
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
Emergency Mobile
Sharing companion (8)
Companion / Roommate
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
Arrival date (9)
Arrival Date

Month
day
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 *
To proceed, you must mark this yes to
indicate that you read the disclaimer,
terms, and conditions.
* Required field(s)
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