HOMESTAY APPLICATION FOR NEW STUDENTS

HOMESTAY APPLICATION FOR NEW STUDENTS Name: Family Name First Name Date of Birth: Year Month Day Sex: Female Male Address: House or apartment number, street name, etc. City/Town Province Country Postal Code Extra space if required Telephone: ( ) Area Code Email: Please print clearly Fax: ( ) Area Code Private fax at home? Fax at Company or store? Please check one of the above options. Estimated Arrival Date in Canada: * Please complete this as well as the Student Arrival form FAMILY MEMBERS: Name Relationship Date of Birth Occupation Father Mother 1/15

PERSONAL BACKGROUND: Do you have any medical concerns, allergies or disabilities? Yes No If yes, please explain: (Please attach a separate paper if you require more space). Do you require a special diet? Yes No If yes please specify. (e.g.: vegetarian) Note: We cannot guarantee that your homestay family will be able to accommodate a special diet. Students with a special diet may be required to assist in meal preparation. Food preferences: I like: I dislike: Please describe your interests, hobbies, favourite activities or sports: Do you smoke? Yes No Note: It is illegal for minors to possess alcohol and/or tobacco. Students who have not yet quit smoking must do so prior to joining our program. Do you play a musical instrument? Yes No If yes please specify. (e.g.: piano) Religion: Buddhist Christian Muslim None Other If other, please explain Do you regularly attend religious services? Yes No 2/15

The Following Questions are to assist your host family in knowing more about your background. Please answer as best as you can. How long have you been studying English? Have you ever traveled or lived outside of your home country? Yes No If yes, where and for how long? On average how much time do you spend traveling to school? Do you travel by bus, train, subway, car or bicycle or do you walk from home? Please explain: What is your long-term goal for the future? (e.g.: for work) How many hours a week do you usually spend on a computer? How many hours a week do you usually watch TV? Do you help with household chores at home? Yes No If yes, what chores do you do? How would you describe your personality? Check all that apply Independent Energetic Hardworking Outgoing Friendly Quiet Athletic Casual Serious Social Studious Shy Please write below any comments that you think are applicable to the choice of your host family. 3/15

HOST FAMILY PLACEMENT INFORMATION: FAMILY TYPE: (You may number your choices in order of preference.) Young Single Person Family with children Middle Aged Couple Family without children Older PETS: Do you have an allergy to an animal? Yes No If yes, please list here: Please list any pets that you absolutely cannot live with in the same house: Note: Students should be aware that by stating they do not like a particular pet they may be excluding themselves from a homestay family which meets their other preferences. SMOKING: Non-smoking family preferred I am a non-smoker, but a smoking family is acceptable No preference FAMILY INVOLVMENT: Using the scale 1 to 5, please indicate the level of interaction you would like to have with your host family. Example: 5 indicates daily conversation and involvement in activities and so on. 1 indicates little conversation and no interest in participating in activities. Little involvement 1 2 3 4 5 Very Involved I understand the above information will be used to assist the Homestay Manager with matching me with a homestay family. However, I understand that the Homestay Manager cannot guarantee that the chosen homestay family will meet the all of my requests. I authorize the New Westminster School District to share the information collected in this application with potential host families. Student Signature Date (month / day / year) Parent Signature Date (month / day / year) 4/15

TERMS AND CONDITIONS Please (check) each box after reading The student is expected to follow the rules set out by the host family, including curfew. The student has the right to have the rules clearly explained to them when entering the homestay. The student is expected to be home for meals or to phone ahead of time if not returning home The student will ask permission before inviting guests into the host family home. The student will not store perishable food in his or her room. The student and his or her parents will be responsible for any expenses incurred by the student in the homestay (including phone or Internet charges) and will be responsible for any damage caused by the student. The student will not be asked to baby sit children in the host family at any time. Both the student and host family members are to treat each other with respect, politeness and consideration. The student must have written permission of program staff, host families and the student s parents to travel out of the lower mainland of British Columbia. If a student intends to travel outside of the lower mainland, he or she must be accompanied by a host family custodian. Student must not travel to the United States unless accompanied by a host family custodian. The International Education Office must receive written permission from the student s parents prior to traveling to the USA. Prior to traveling outside of the lower mainland or to the United States students, parents of students and host family custodians must complete a Travel Form available at the International Education Office. A student may receive or learn personal information about a host family including medical information. The student will use this information only for the purposes for which it is shared and to treat any sensitive personal information about host family members with a high degree of confidentiality. By signing this page the student and the parent(s) agree to the above terms and conditions. Student Signature Date (month / day / year) Parent Signature Date (month / day / year) 5/15

ATTACHMENTS To complete your homestay application, please attach the following documentation: 1. A collection of photos showing you and your family members, friends, pets, school clubs and so on. 2. Any required medical information (This is strictly confidential). 3. A student letter of introduction to the host family. Please do not include requests in this letter. Requests should be in the main part of the application. Your letter of introduction should include the following: Why you are interested in studying in another country. Your future goals and ambitions Your hobbies and interests Any other comments you would like to include (except requests) 4. Letter of introduction to the host family from the student s parents (optional). 6/15

WAIVER Student safety and security is a high priority for the New Westminster School District. The International Education Program carefully screens and selects homestay families. It has also established a process to respond to concerns identified by students. However, the New Westminster School District and its employees do not assume responsibility for things that happen in the home outside of its control. The parents waive and release from liability the Board of Education of School District Number 40 New Westminster, including its trustees, employees, officers, servants and agents from any and all claims, demands or suits for any injury, loss, damage or expense that the student may experience resulting from or connected with the student s participation in the School District International Education Program, including its homestay program. Parent Signature Date (month / day / year) Parent s Name (please print) 7/15

HOMESTAY GUIDELINES FOR STUDENTS Living with a Canadian Homestay family can be a wonderful cultural experience for International students. While in homestay, students have the opportunity to practice their English skills and to be part of a Canadian family. In order to make the most positive experience for students and homestay families, the following Guidelines have been provided. These guidelines must be followed if a student decides to live with a homestay family provided by the International Education Homestay Program. All students must live with their guardian, or a Canadian Homestay/Custodian. All host families in the Homestay Program are English speaking Canadian residents; however, they may come from diverse ethnic and cultural backgrounds. Each Homestay/Custodian has been carefully screened and visited by the Homestay Manager. We look for families who: Are kind and friendly Enjoy sharing Canadian culture with those of other countries. Live a maximum of 45 minutes traveling time from the School District If you have submitted a complete and signed application for the homestay program the Homestay Manager will begin to match you with a suitable host family. From receiving your application to sending you a host family profile is approximately two weeks depending on volume. THE HOST FAMILY WILL PROVIDE THE FOLLOWING: A private room with a closet, bed and bedding, window, desk, lamp, chair, clean linen and towels, soap and toilet paper. Three meals a day, one of them a hot meal. Your host parent will show you how to make your breakfast and lunch, or they will make it for you. Use of common areas in the house (living room, bathroom, kitchen etc.), telephone and laundry facilities. Invitations to the student to join in family activities. A safe English-speaking environment. Custodial supervision and help while you adjust to life in Canada. Airport pick up when you arrive in Canada. STUDENT RESPONSIBILITIES 1) Students are responsible for keeping their room, the bathroom and other parts of the host home that they use clean and tidy. 2) Host Families will explain their house rules to students when they begin the homestay with their host family. As outlined in the Terms and Conditions section of your application students are required to respect these rules. The rules will be no different for any host children in their family. Host family rules are in place to ensure the safety and well being of the students. 3) It is illegal for students to possess alcohol, tobacco and/or illegal drugs. The legal age for drinking alcohol and possessing tobacco in Canada is 19 years. Students who have been using drugs and or alcohol may be dismissed from the program and must return home. 8/15

4) Respect your host family and try to integrate with them. They will assist with situations where a mistake has been made. 5) Students are responsible for their own transportation. Once you arrive your host family will orientate you to the local transportation system. Students can receive a transit schedule from the public library or receive one from their host family. 6) Do your best to speak only English when you are around your homestay family. When a friend who speaks your language visits your home do your best to speak English in front of your host family even with the friend who speaks your native language 7) If you like to spend a lot of time on the phone, it is recommended that you purchase a cell phone or speak with the homestay family about having your own phone line installed. As stated in the Terms and Conditions section of your application the student is responsible for the cost of cell phones, personal phone lines or personal Internet connections. *Students who want to have a cell phone should get a Pay As You Go phone. Phones that require a contract will need to be co-signed by your host family. 8) Always let your homestay family know where you are. While you are living with a homestay family in Canada, they will be acting as your parents. Always let them know where you are, and ask permission before planning sleepovers, or having your friends visit at your home. *If you are missing for 24 hours, they are required to report you missing to the Police. 9) Student property may not be covered by the host family s insurance. Students may wish to purchase private insurance to cover their personal belongings 10) Students may want to bring their own lap top computer, camera and other items, which will make their adjustment to Canadian life easier as well as more enjoyable. 11) As stated in the Terms and Conditions section of your application you are expected to be home for meals or to phone ahead if you will be away for a meal. Families are expecting you to be home for dinner and will be preparing your meal for you. Homestays need to be informed if there are any changes in plans. 12) As stated in the Terms and Conditions section of your application students are not permitted to travel outside of the lower mainland unless supervised by a responsible adult 25 years or older. As well, students must provide the International Education Program with written parental permission for the trip. This permission needs to be faxed to our office prior to the scheduled trip. 13) As stated in the Terms and Conditions section of your application students must not travel to the United States unless accompanied by a host family custodian over the age of 25. The International Education Office must receive written permission from the student s parents prior to traveling to the United States. 14) Students are not allowed to entertain friends of the opposite sex in their bedrooms. 15) You will be given a key to the Homestay s house. Be very careful with your key because if you lose it, you may have to replace the locks to the entire house at your expense. 9/15

16) If you are the last person to leave the house, it is your responsibility to make sure that the lights are turned out, and your windows are closed, and the doors are locked. Also, please make sure you understand how to turn on and off house alarms if your homestay family has any. 17) Do not carry large amounts of money with you, or leave large amounts of money in your room. Be careful with your valuables. Your homestay family is not responsible for your property if it is lost or stolen. Your host family will assist you in setting up a bank account. 18) As stated in the Terms and Conditions section of your application students will be expected to pay for any damage that you cause to the host family s property. 19) If students are having difficulties in their homestay it is important to come to see the Homestay Manager as soon as possible. The Homestay Manager will offer solutions to assist with the issue at hand. This may include the Homestay Manager speaking with the host family regarding the issue. 20) Moving All moves must be approved by the Homestay Manager. If a student must move, they are required to give one calendar month's written notice to both the Homestay Parent and to the Homestay Manager. Students must also have written parental permission to change their homestay. EXAMPLE: If the student wants to move from their host home on October 31 st (and permission has been received) one calendar month means that the student must tell their host family no later then September 30 th. The month of October is the one calendar s month notice. If the required notice is not given, you may lose your homestay deposit. 10/15

GUIDELINES FOR HOMESTAY FEES The following guidelines are to assist you with the homestay fees policy and to avoid misunderstandings. If you have any questions please do not hesitate to contact our office. 1. Application Fee The application fee for the homestay program is $300.00. The Homestay Manager will begin to search for a suitable host family when the fee has been paid. 2. Monitoring Fee Students pay a $100.00 per year ($50.00 per semester) monitoring fee. This fee assists in covering the costs of the Homestay Manager who ensures student well being in their host homes and monitors homestay conditions. This fee is not charged in the first year of the program. 3. Nightly Fee When a student arrives to begin the semester or vacates at the end of the semester on a date other then the first of a month or last day of the month, the fee of $28.00 per night will be applied to these dates. 4. Airport Pick-Up Fee There is an airport pick-up fee of $50.00. Students are to pay this fee directly to their host family. It is recommended that students pay this fee together with their $28.00 per night fee for nights when first arriving in the host home. 5. Monthly Fee The monthly fee is $850.00 per month. The monthly fee for grade six, seven and eight students is $900.00. The monthly fee does not change from September to May regardless of whether the student is absent for holidays or returning home early. Students ending the semester in June and not staying the full month can pay the nightly fee for the month of June. 11/15

6. Monthly Fee Payment Process Students can pay this fee in the following ways: (A) The student may pay their host family in cash. (B) The student may give their host family a cheque. (C) The student can arrange with their host family to have the monthly payment wired to the host family account. (D) Students may have arranged through their representative to have their monthly payments distributed to the host family through the school district. Never pay your host family more then one month of host fees at a time 7. Summer Time Fee Structure Long-term students taking classes during the entire summer are required to pay the normal monthly fee. Students who are taking summer classes but returning home before August 15 th are required to pay one half of the monthly fee for August ($425). Students staying past the 15 th of August are required to pay the full monthly amount ($850). Students who are returning home at the end of June but returning to Canada at the beginning of September to resume school may be asked to pay $200.00 for the months of July and August for a total of $400.00. o $225 per month for students in grade 6, 7 and 8. 12/15

HOMESTAY STUDENT AGREEMENT To avoid future misunderstandings and problems, please place an in the box to indicate that you have read and understand the following: The student is responsible for the full monthly fee from September to May regardless of vacations taken throughout the year. The per night rate when a student arrives to begin the semester or vacates at the end of the semester on a date other then the first of a month or last day of the month is $28.00 per night. There is a one-time airport pick up/drop off fee of $50.00 when first being picked up by a host family at the airport. The monthly fee is $850.00 per month due on the first of the month. The fee is $900.00 for grade six, seven and eight Middle School students. Students who need to move are required to give their host family one calendar month s notice unless mutually agreed upon by the host family and the student. I have read the Homestay Information provided by the New Westminster School District. I am willing to participate in the Homestay program and follow all the Homestay guidelines provided by the School District. I realize that if I violate any of the Homestay guidelines, I will be asked to leave the Homestay program. I have provided all of the information of my expectations of Homestay to the Homestay Manager. I understand that the Homestay Manager will do his or her best to arrange a homestay/custodian that best fits my expectations. I will accept the arrangements made by the Homestay Manager. Student Signature Date (month / day / year) Parent Signature Date (month / day / year) 13/15

STUDENT ARRIVAL FORM Please send us this completed form when you know your flight information. This will allow your host family to make arrangements to meet you at the airport. Please be aware that students are expected to attend the orientation session at the beginning of the semester in which they are starting school. Student Name: Family Name First name Arrival details (Vancouver date and time) Arrival Date Arrival Time: Airline/Flight No: Departure Date (if known): Departure Time/ Airline (if known): If there are any changes to the above information in the future, please notify us immediately. After you receive your information regarding your Homestay family, you should also notify your host family of any change of arrival plans. Your host family will pick you up at the airport. If you do not require this service, please give us the name, address and phone number of the person who will be greeting you at the airport: Name: Phone: Address: Email: (please print clearly) Have A Nice Trip to Canada! 14/15

COMPUTER USAGE POLICY Due to the increase in computer related issues that have been brought to the attention of the Homestay Manager a policy regarding the usage of computers in the New Westminster School District Homestay Program is required. The reasons for a policy for computer usage are as follows: 1. Lateness for classes due to students using the computer into the early hours of the morning and consequently sleeping in. 2. Skipping meals due to using the computer or rushing in the morning. 3. Illness and lack of attentiveness in class due to excessive late night use of the computer. 4. Little to no interaction with the host family due to students spending most of their time in their rooms for hours on end using the computer. 5. Little to no progress in English ability. Students do the vast majority of their computer usage in their own language. This of course is defeating the purpose of being in an immersion environment. Students who spend countless hours on the computer are usually students who will have mainly ESL classes at school and their progress in moving into credit courses needed for graduation is being severely impaired. 6. In the case of one-computer families students have been using the computer to the extent that other family members cannot have access to it. MAXIMUM TWO HOURS PER DAY Students are to use either their own or their host family computer for no longer than two hours per day. The reasons for this policy are not to punish students who enjoy using their computers but to try to solve the above problems as well as to encourage students to maintain a healthy balance in their lives. Students who are constantly using their own or their family computer more than two hours per day after being asked not to may lose the privilege of using the computer or other consequences deemed appropriate by either host families or the International Education office. We would much rather see students interacting with their host family and friends and taking an interest in school based activities rather than being parked in front of a computer for hours on end. This policy is consistent throughout the New Westminster School District Homestay Program. DOWNLOADING OF INAPPROPRIATE MATERIAL As a credit to our students this has never been an issue with computer usage. However, students should be aware of the following policy regarding pornography and inappropriate Internet sites: 1. When it is discovered that a student has been downloading pornography the student s parents will be informed. Following this the student will sign a contract specific to Internet usage. The student may be required to speak with his or her counselor regarding the situation. 2. On a second occasion where the above contract has been broken a decision will be made by the International Education Department as to an appropriate response. If you have any questions about this policy please don t hesitate to contact the international office. Thank you very much for your cooperation! 15/15