Host Family Application Host Family Application Form Name* First Last Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Phone (Home)Phone (Mobile)Email* Family members who live at home: (please list all the family members who are living at home with you)* What is the main language spoken in your home?*Are there any smokers in your home?*YesNoHow did you hear about our program?*Have you hosted students before?*YesNoIf yes, please indicate what school you hosted for, nationality, age and length of stay.*School/ProgramNationalityAgeLength of stay Do you live in a:*HouseTownhouseApartment/CondoDo you have any pets in the home?*YesNoIf yes, what type?*Do you have wifi/internet in the home?*YesNoWhy are you interested in hosting a student from overseas?*Do you prefer male students, female students or no preference?*MaleFemaleNo PreferenceAre you willing to accept students under 19 and act as their custodianship?*YesNoWhat is the nearest intersection near your home (eg. Cambie/Broadway)*Please indicate the most convenient public transit route to Columbia College (include bus number, frequency that buses run and approximate time to get to the college*What are your hobbies and interests? Please give details:*Please write anything that you feel is important for students to know about your household (food/diet, rules etc.)*Please write a personal message to your student. This will make him or her feel welcome even before they arrive.*I am willing to have a Police check done in order to become a host family member for Columbia College?*YesNoIf no, please give reasons*Additional Comments:CAPTCHAEmailThis field is for validation purposes and should be left unchanged.