| HOMESTAY phone: 416-537-8881 |
| Executive Information Form |
| Please help
us to find the best homestay for you. Answer the questions below and send us this form. Choose one of these addresses: E-mail: klynn@ica.net or Fax: 416- 537-9984HOMESTAY |
| 1. Your name: |
| 2. Male __ Female ____ |
| 3. Your
address: Street Apartment number City Country |
| Phone number. List more than one if you want: |
| Fax number: |
| E-mail address: |
| 4. Have you registered with an educational provider? Yes __ No __ |
| If yes, name and
address of the educational provider? When does school start?
|
| 5. (optional) If no,
do you need help in choosing an educational providerl? What do you want to study?
|
| 6. Occupation: |
| 7. What is your age? 20-25 __ 26-30 ___ 36-40 __ 40+__ |
| 8. Hobbies, special
interests:
|
| 9. Do you wish to be
picked up at the airport? The cost for pick up and return is $150 Canadian. Yes, pick-up and return __ No thanks ___ |
| 10. Arrival Date:
day ___ month_____ year_____ Flight number: Airline: Time of arrival am pm |
| 11. Departure Date: day ___ month____ year_____ |
| 12. Do you have allergies? Yes __ No ___ |
| If yes please describe. Food?...................................................... Other? ......................................................... |
| 13. Can you live with a dog? A cat? |
| 14. Do you prefer to live with children? |
| 15. Do you have any other preferences? |
| Thank you very much! We will be able to find a good homestay for you. All of our homes are inspected and our homestay hosts are trained. We hope you will come and stay with us! |
| WELCOME TO CANADA |
| © HOMESTAY 1999 |