Please help us to serve you better :

Please provide us with the following  information:

Note: We at Vancouver Homestay House are committed to dealing with as many nationalities as possible. However, because we are based in Canada we can only correspond in English and are sorry for any inconvenience this may cause you, 

First Name
Last Name
Street Address
Address 2
Zip/Postal Code
Home Phone
Sex Male Female


Do you smoke ?      (If yes outside only)

Do you have any diet restrictions?

If yes, please explain?

Do you have allergies ? 

If yes, what?                

What is your purpose here?       

What school are you attending? 

Street address of school?          

Do you have medical insurance?   

Do you need airport pickup?          

How long do you need a Homestay for?

Start Date    

End Date     


Tell us about yourself?

Do you have any questions to ask us ?


Person to contact - In case of Emergency:

Work Phone
Home Phone

Please answer all the questions as best you can or we will not reply to your request.... Be patient and we will get back to you within 24 hours.

I have read the Terms of use and Privacy policies of Vancouver Homestay House and I agree to abide by these terms upon acceptance of this application.


We will be your family here is Canada.







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