Homestay Host Application


Please supply all information requested. Except for the specific, limited uses indicated in this form, all information that you supply will be kept strictly confidential.

Host Information

Name of Applicant

Home Address:

Children/Other Residents Living at Home:

Resident 1:

Home Information

*Students must be able to commute to Lakehead University by bus in 45 minutes or less.

Hosting Information

Lifestyle Information


Please provide 2 references (not relatives)

Reference 1

Reference 2

I/We declare that all the information provided in this application is accurate and understand that any inaccurate information may invalidate this application. I/We agree to submit a criminal record check for each household member over the age of 18. I/We understand that the Homestay Host application is not complete until the Lakehead University English Language Centre receives all criminal record checks. Please be in touch via email to with any questions or concerns. Thank you for your application!