Okanagan Homestay with Heart

Host Family Application
Please print out this form and complete all relevent information to the best of your ability,
then mail to the following address.

Once the following form has been received by us, a representative from OHH Canada will contact you and arrange an appointment for an in-home interview.

Any information supplied will be confidential and will not be shared with anyone not connected with Okanagan Homestay with Heart.

Name:

Married:     Single:     Common-law:     Other:
Spouse's Name:

Email address:

Home Phone:

Address:

City:

Occupation:
    N/A
Employer:
    N/A
9-5:         Part time:         Shift work:
Work Phone:
    N/A
Spouse's Occupation:
    N/A
Spouse's Employer:
    N/A
9-5:         Part time:         Shift work:
Spouse's Work Phone:
    N/A

Names of any other Adults living in household:

Relationship to applicant:
Mother: Father: Grandmother: Grandfather: Friend: Other:
Names and Ages of children in the house:
Child 1    Age    Birthdate-mm/dd/yy
Child 2    Age    Birthdate-mm/dd/yy
Child 3    Age    Birthdate-mm/dd/yy
Child 4    Age    Birthdate-mm/dd/yy
Name of school attending:
Child 1   or Home Schooled
Child 2   or Home Schooled
Child 3   or Home Schooled
Child 4   or Home Schooled
What types of activities do the children of the house participate in:

What are the hobbies and/or interests of the adults:

What are your families favourite recreational pastimes:

Do you have any pets:
Yes      No
If yes, what kind.

Inside      Outside      Both
Is your family on any type of restricted diet (i.e. vegetarian):
Yes      No
If yes please explain:

Does your family attend church on a regular basis:
Yes      No
Would you require your student to attend as well:
Yes      No
Are there any smokers in your family:
Yes      No
What are the rules regarding smoking in your home and on your property:

Please describe the events/schedule of a typical week day in your household:

Please describe the events/schedule of a typical week end in your household:

Why would you like to host an International student:

Have you hosted an international student before:
Yes      No
Are you currently hosting with an organization:
Yes      No
When is the most convenient time for an in-home interview:
Day:
Mon.   Tues.   Wed.   Thurs.   Fri.   Sat.   Sun.
Time:
8 am   9 am   10 am   11 am   12 pm   1 pm
2 pm   3 pm     4 pm     5 pm    6 pm   7 pm   8 pm

Thank you for taking the time to fill out this form, please remember all information
is confidential and will not be shared with anyone not connected with
Okanagan Homestay with Heart.

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