May 16, 2016

Application Form For Students

First and Last Name (required)

Your Email (required)

Home phone number

Work or cell phone number

Street Address

Gender (male/female)

Student type

Field of study

Country of origin

When did you arrive in Canada?

Languages spoken (other than English)


Allergies (dietary or pet)

What do you hope to gain from this experience? (2-3 sentences)

Do you plan to bring a friend to meet your Friendship Family? If yes, what is his/her name?

How did you find out about Home Away From Home?

Is there anything else we should know about you?