寄宿家庭注册

(*项是必填项)
Personal Information:
*Family Name: *Given Name:
*Email:



(Please make sure to complete acourse registration application before applying for a home stay.)
Background Information:
How many people are in your family?
This includes: Mother   Father   Brother(s)   Sister(s)  
Is this your first time away from your family? Yes   No  
Have you visited a foreign country before? Yes   No  
Is this your first home stay? Yes   No  
Emergency contact:
(Provide as much information as possible about the person we should contact in case of emergency.)
Family Name: Given Name:
Relationship:
Address: Unit/Apt:
City: Prov/State:
Postal Code: Country:
Telephone: Fax:
Email:



Health:
1. Do you have any dietary (food) restrictions? Yes   No  
If yes, please describe:
2. Do you have allergies? Yes   No  
If yes, please describe:
3. Do you smoke? Yes   No  
4. Do you prefer a smoke-free environment? Yes   No   No Preference  
Personal Preferences/Interests:
(Please provide as much information as possible. This will allow us to find you a suitable family.)
1. What foods do you like?
2. What foods do you dislike?
3. Would you prefer a home with:
Dogs Yes   No   No Preference  
Cats Yes   No   No Preference  
Another Student Yes   No   No Preference  
Young Children Yes   No   No Preference  
Teenagers Yes   No   No Preference  
4. What kind of hobbies and entertainment activities do you enjoy?


5. Do you enjoy outdoor activities or sports? Yes   No  
If yes, please describe:
6. Are there any particular places you would like to visit or things you would like to do in Canada?


7. Check the words that best describe you?
Social   Independent   Outgoing   Shy   Serious   Relaxed  
Quiet   Adventurous   Cheerful   Responsible   Funny   Creative  
8. Please describe yourself.