INTERNATIONAL STUDENT HOMESTAY APPLICATION To assist us in finding you the right homestay, please complete this application and return it to the International Centre at least two (2) weeks prior to your arrival or you will not be guaranteed homestay. Please read the options carefully before making your choices. If you arrange for homestay accommodation and withdraw from the college you are required to pay $350. YOU WILL BE REQUIRED TO BOOK YOUR AIRPORT PICKUP ONCE YOUR HOMESTAY HAS BEEN CONFIRMED. PERSONAL DETAILS Click to Print ESTIMATED DATE OF ARRIVAL (MM/DD/YYYY): ________________ Male Female Under 18 Flight #: ___________________ ______________________________________________ ______________________________________________ Family name/Surname Given name Student number: ___________________________ Date of birth (mm/dd/yyyy): ___________________________ Address: __________________________________________________________________________________________ City: _____________________ State:________________ Country: ________________ Postal code:______________ Home phone: ______________________ Nationality: _____________________ First language:________________ Student’s e-mail: ________________ ___________________________________________________________________ Agent’s email:_______________________________________________________________________________________ Are you an eap student? Yes Start date: No Program of study:_________________________________ Barrie Campus: ______________________ Finish date: Length of Stay: Visa Status: Approved Pending Haven’t Applied Homestay Meals Included (with a family) The cost is $750/per month which includes three meals a day, rent and all utilities (electricity, water, Internet, TV, etc.). You can expect to have dinner with your host family (at least 4 times a week) and learn about Canadian foods. You may have to prepare your own breakfast and lunch, however the ingredients will be provided by the host. If there is special food you like, you may be required to purchase them yourself. Homestay NO Meals Included (with a family) The cost is $500/per month which rent and all utilities but NO FOOD OR MEALS. Students have full access to the kitchen to prepare their own food. You will still get to enjoy the Canadian experience with a Canadian family who can help you adapt to living in Canada. EMERGENCY CONTACT INFORMATION Contact Persons Name: Relation to student: __________ _ Address: City: Postal/Zip Code: Telephone Number: ______________ State: Country: _________________________________ Email:______________________________________________________________ Fax Number: ___ Georgian College, 1 Georgian Drive, Barrie, Ontario, Canada, [email protected] _______ 1 MEDICAL INFORMATION Please check allergies or special needs you may have and list each. If you do not have any allergies or special needs please move on to the next questions. Allergic to animals. If yes, what animals _________ Allergic to medications. If yes, what medications ___________ Allergic to foods If yes, what foods _____________ Other allergies (please list) _________ Are there any other dietary/physical or other needs that we should know about? _____ _ (Please explain what these needs might be) ________ _ _ _____ ______ HOMESTAY PREFERENCES Make a selection below only if you feel strongly about living in a Homestay with these preferences. Most Canadian homes have pets and some have children as well. Please note that we will endeavor to place students in the most suitable accommodations available, however the International Centre cannot guarantee that all student preferences will be met. I would prefer a Homestay without young children (young children can range from babies to young teens) I would prefer being the only student from my country in the homestay I would prefer a Homestay without certain pets. I do not like these types of animals: ________ ______ I am a smoker and would prefer a homestay that will allow me to smoke outside (smoking is not permitted inside the home) STUDENT DESCRIPTION Introduce yourself. What do you look forward to in Canada? What kind of person are you? Please include a photo of yourself: Photo Georgian College, 1 Georgian Drive, Barrie, Ontario, Canada, [email protected] 2 PLEASE CHECK THE APPROPRIATE BOXES THAT WOULD BEST DESCRIBE YOUR PERSONALITY Leader Studious Shy Social Tidy Independent Open Minded Cooperative Adaptive Traditional Talkative Outgoing Sensitive Independent Dependable Have you lived away from home before? Yes No If yes, for how long? Have you ever travelled to a western, developed country before? Yes No If yes, where and for how long? Have you ever been employed? Yes No If yes, for how long? Have you ever gone to college or university before? Yes No Do you consume alcohol? Yes No Are you a vegetarian? Yes No Are there any food restrictions or religious requirements that the homestay hosts should know? Yes No If yes, please explain: ** Please note that it is illegal for anyone under the age of 19 to purchase alcohol or tobacco in Ontario, Canada. ** I keep my room: I socialize/ party: I go to bed: I like music/ TV: I like sports: I know how to cook: I do chores: Very neat and clean Not often Early A little To play Very well Often Reasonable Sometimes Varies Sometimes To watch only Basic foods Rarely Less organized Often Late Very much Never Not at all Never Sports/Hobbies: What are your favorite foods? What foods do you dislike? Please indicate your level of English Advanced Listening Speaking Intermediate Low Intermediate Beginner Reading Writing Number of years you have studied English: Georgian College, 1 Georgian Drive, Barrie, Ontario, Canada, [email protected] 3 PAYMENT OF FEES Payment is exchanged between the host and student. You must pay first and last month’s rent upfront when you arrive. Your last month’s rent is used as a deposit for the homestay host and you are expected to make another payment after the first month. You should be prepared to come with 3 months payment for your first two months. Payment must be made in Canadian dollars (Full Homestay $1500 upon arrival, Shared Homestay $1000 upon arrival). Payment will be made on a month by month basis. Payment begins the day of the month you arrive at the homestay. For example, if you arrive on August 16th you are expected to pay first and last ($1500) and then make your second month’s payment ($750) on September 16th. The fee per day is $25 if there are extra days to add at the end of your stay. For example: if your rent is always due on the 24th of each month but you are moving out on the 30th, you can pay an additional 6 extra days ($25 per day x 6 days) for a total of $150 to the host. Full fees are to be paid if you choose to be away from your homestay (vacation, school break etc.) unless otherwise agreed upon by the host family. LENGTH OF STAY IN YOUR HOMESTAY You are welcome to stay in your assigned homestay home for the duration of your studies, unless there is a change in your host’s ability to host you or if your housing needs change. You are required to stay in homestay for a minimum of two months, and provide 1 months’ notice to the host before you leave. If you do not complete a minimum two months stay or give 1 months’ notice before you leave your homestay, there will be no refund available. REQUEST TO CHANGE HOMESTAY If you require a change in homestay you must email the Housing Coordinator and set up a meeting to discuss your request. There may be a fee to change homestays. NOTICE BEFORE MOVING Students must give written notice to the Homestay host before leaving. Notice must be given at the beginning of the rent pay period. In the event of a health and/or safety issue, the College will move the student to another house without delay or forfeiture of security deposit. In the event the student wishes to move due to personal reasons they are responsible for finding their own alternate accommodation. Georgian College, 1 Georgian Drive, Barrie, Ontario, Canada, [email protected] 4 I HAVE READ, UNDERSTAND AND AGREE TO ABIDE BY THE TERMS OF THE INTERNATIONAL STUDENT HOMESTAY APPLICATION Dated (mm/dd/yyyy): ______________ NAME OF STUDENT (print) STUDENTS SIGNATURE ***If the student is under 18 years of age this document must also be signed by a legal guardian NAME OF GUARDIAN (print) GUARDIAN’S SIGNATURE PLEASE FORWARD YOUR HOMESTAY APPLICATION TO: [email protected] According to Canadian law, the personal information we are collecting will be used to contact family members in case of emergency and to help you find accommodation. For further information about the information requested on this form or the purpose for which the information will be used, contact the Homestay Coordinator at 728-1968 extension 1392.Georgian College is compliant with the Freedom of Information and Protection of Privacy Act (FIPPA) and endeavours to protect your personal information in compliance with this Act. If you have any questions about FIPPA, please contact the Access and Privacy Consultant at [email protected] or 705.728.1968 ext. 5770. Georgian College, 1 Georgian Drive, Barrie, Ontario, Canada, [email protected] 5
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