Student Homestay Application Form

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.

Please be advised that only students studying in Lakehead University's English Langauge Program are eligible to participate in the Homestay Program.

Student Information

Student Questionaire

I declare that all the information provided on this application is accurate and understand that any inaccurate information may invalidate this application.

Homestay with Meal Homestay without Meals
Placement Fee (non-refundable) $400.00 $400.00
Refundable Damage Deposit*In the event of damages $400.00 will be charged to your Lakehead University Account upon inspection and review $400.00 $400.00
Homestay Fees $900.00/month $675/month

I understand and agree to the Payment, Schedule, Refund Policy and Terms of the English Language Centre Homestay Program.

New fieldset