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
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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]
_______
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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]
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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]
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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]
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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]
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