Homestay Information Form Thank you for choosing to host with GoCanada. To be eligible to host, we kindly ask that you fill out the following Homestay Information Form. Homestay Information Form "*" señala los campos obligatorios 1Homestay Details2Head of Household Information3Additional Questions Homestay DetailsMain contact person* First name Last name Email of main contact*Homestay address* Street name and number City Province AlbertaBritish ColumbiaManitobaNew BrunswickTerranova y LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal code Are you considering the possibility of moving from this address within the next 12 months?*If yes, please explain.Languages spoken at home*Total number of bedrooms*Total number of bathrooms*Please list ALL family members that will be residing with you during the upcoming academic year and/or summer months. If you have kids, please include their date of birth (DD/MM/YYYY) and what school they will be attending.*Number and type of pets living at the household.*How many international students do you typically host at the same time?*Hosting duration preferences*Please select all that apply. Full academic year (10 months) Semester (5 months) Short term (1 to 4 months) Respite care (several days to a couple of weeks) Summer program (1 to 6 weeks in July/August) Student preferences*Please select all that apply. Male student Female student Younger student (13 to 15 years old) Older student (15 to 18 years old) Do you have any other student(s) scheduled to stay with you during the upcoming academic year and/or during the summer months?*If yes, please provide additional details such as duration of stay, what program the student will attend, as well as age, sex, country of origin, and languages spoken by the student. Please update us if and when you do undertake to host another student. Please bear in mind that we do not place more than one Spanish-speaking student at the same homestay. If you do decide to host another student, please make sure that they do not come from a Spanish speaking country. Additionally, it is best that both students are of the same sex. If they are of opposite sexes, we will need to seek permission from both students' legal guardians. Head of Household 1Full name* First name Last name Phone number*Email*Date of birth* Month Day Year Occupation*Is there a second head of household?* Yes No Head of Household 2Full name* First name Last name Phone number*Email*Date of birth* Month Day Year Occupation* Additional QuestionsHow would you describe your family's lifestyle and household environment? Please select all that apply.* Our household is always on the go – A color-coded calendar is (or would be) essential to keep up with everyone’s schedules! Our home is full of energy and lively conversations Our home is a peaceful, quiet retreat We value our personal space and independence Our home is neat and well-organized We embrace the chaos – life’s too short to worry about every little mess! We have open-minded views and value diversity We have traditional values and a structured lifestyle We love hosting friends and family – our home is always buzzing with visitors! We interact with each other in a polite and respectful manner We have a casual, laid-back approach to communication We believe in clear rules and expect them to be followed – no exceptions! We’re flexible with rules – as long as there’s mutual respect and understanding, we’re open to discussion We’re approachable and always open to a chat – our door is always open Religion is an important part of our daily routine and values We are passionate about politics and enjoy discussing current events We value education and academic achievement We are actively engaged in our local community We are sports enthusiasts – both watching and playing! We love the outdoors and are always up for an adventure We enjoy relaxed weekends without too many commitments Our weekends are packed with family activities and outings If you have children, please describe any hobbies, sports, or activities they are passionate about or regularly participate in.*If you do not have children, please put "N/A".Briefly describe any specific rules that children in your home are expected to follow.*If you do not have children, please put "N/A".Do you make regular trips outside of the city (eg. trips for sports competitions, trips to the cottage, etc.)? If yes, please provide details.*Please specify the religion practiced by the members of the household, if any, and degree of involvement with the religious community.*Does anyone in the household smoke tobacco? If yes, please specify who.*Does anyone in the household smoke, use, or grow marijuana products? If yes, please provide as many details as possible.*Does any member of the household adhere to dietary restriction(s) (eg. lactose-free, gluten-free, vegetarian, vegan, etc.)? If yes, please specify.*Would you be open to hosting a student with special dietary restrictions (e.g., gluten-free, vegan, vegetarian, or pescatarian)? If yes, please specify which dietary restrictions you are comfortable accommodating.*Does any member of the household suffer from allergies? If yes, please specify.*What hobbies does your household regularly practice and enjoy?*Please describe a typical weekday schedule for your household, including activities that are shared by all family members. Be as specific and descriptive as possible.*Please describe a typical weekend schedule for your household, including activities that are shared by all family members. Be as specific and descriptive as possible.*How many times a week do you typically eat dinners together as a family?*Do you often go out for meals/get takeout/delivery? On average, how many times a month do you go out for meals or get delivery/takeout?*Please describe any past experience hosting international students.* Δ