LCS | International Student Program
International Homestay Application Form
Parents Names *
Your answer
Street Address *
Your answer
City, Postal Code *
Your answer
Phone Number *
Your answer
Alternate Phone Number
Your answer
E-mail Address *
Your answer
Parents Occupations *
Name, Occupation, Employer, Normal working hours
Your answer
Children and Other Family Members *
Name, Birthdate, Relationship, School/Occupation
Your answer
What is the primary language spoken in your home? *
Your answer
What other languages are spoken in your home?
Your answer
Have you hosted an international student in the past? *
Required
If yes, what nationality and for how long?
Your answer
Why are you interested in hosting an international student? *
Your answer
Please indicate the length of time you would prefer to host
Do you have pets? *
Required
If yes, please list pets:
Your answer
Do any members of your household smoke? *
Required
Briefly describe your home *
Type of home, levels, number of bedrooms, number of bathrooms
Your answer
Briefly describe the room where the student will sleep *
Location, approx. size, furnishings
Your answer
Are you interested in and able to accomodate more than one student? *
Required
What age group would you prefer to host?
(Note: We cannot guarantee your preferences)
What gender would you prefer to host?
What are your family's hobbies and interests? *
Your answer
What kinds of activities would you do that would include the student?
Your answer
What are your family's rules about the use of the telephone and internet? *
Your answer
Briefly describe your family devotional time and church involvement. *
Your answer
How much assistance are you prepared to give your student with school assignments?
Your answer
Please write anything else you feel is important for the student to know about your household.
Example: food and mealtimes, laundry, family rules, etc.
Your answer
Please list two references (non-relatives) that we can contact. *
Name, Phone Number, Occupation, Relationship
Your answer
Are you willing to undergo a Criminal Records Check *
All members of the household, 19 years and older, require a Criminal record check
Required
Any other comments?
Your answer
For more information on your application, please contact: Marlene Bylenga | International Student Coordinator mbylenga@langleychristian.com | 604.533.0839
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