Homestay Guest Application    
       
Application Info
Created on
Homestay location * (1)
Homestay Country *
Select the destination country.
The country you intend to reside
to study and/or homestay.

Please note that our homestay service is currently limited to Canada, USA, Australia, UK, and New Zealand.
School address * (2)
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.
Homestay request * (3)
Start Date *
 mm/dd/yyyy
Select start date that you wish to
start or move into a homestay.
Note: it must be at least three days
from today. Maximum start date a year from today's date.
End Date *
 mm/dd/yyyy
Select homestay end date that
you wish to move out of the homestay.
Note: Minimum end date is ten days in the future. Maximum is two years from start date.
Reason for visit
In couple of words, tell us the
reason why you want to stay
in a homestay
Preferred Meals
Select meal plan that you
wish to get during your stay.
Note: Breakfast or lunch
meals are usually self-service.
Average Homestay Rates
Here is a link to help you research the average
monthly homestay rate by city in order to be able to
set your budget to get successful homestay offers.
Search Average Rates by City!
$ Monthly Budget *
The budget should be a reasonable figure
between. So the success of your placement
may depend on this figure. Good luck.
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
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, ...
Contact person* (5)
Who is the contact person for the applicant? *
Applicant Relative Friend
Agent School Other
Who are you?
Email *
 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
Skype/WeChat
Applicant photo* (6)
Guest / Personal Photo
 
Select File...
Drag an image here
A photo to introduce you to hosts.
Having trouble with uploading a
your image file, check Image Tool
at the bottom of this form
Home address* (7)
Home Address *
Home Address *
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 Email
 Email
The email of your homestay companion
Emergency Mobile
Emergency Phone
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 Time
 hh:mm
Time of arrival if you know by now.
You can add arrival information later.
Agreement* (10)
Disclaimer
I, (the applicant, participant, registrant, student, guest, agent, parent, guardian and/or representative), understand and acknowledge all possible risks related to participating in a homestay program and/or staying in someone's home. I agree to release and hold IHA International Homestay Agency (the agency), its entities, employees, agents, share holders, partners, subsidiaries, and representatives harmless, in part or whole, from all liabilities, damage, injury and/or loss claims. I agree to pay 15% down payment, booking fee, and applicable tax upon finalizing a successful homestay booking. The booking balance will be required in a number of payments after arrival.
Disclaimer *
Yes
 Check mark the box to accept.
* Required field(s)
Submit
        02/18/2018