Student Information
Have you ever been an international student before? *
- Select - Yes No
Student Number *
Sur / Family Name *
Given / First Name *
Age *
Gender *
- Select - Male Female
Marital Status *
- Select - Single Married
E-Mail Address *
Student Questionaire
Do you have any allergies? *
- Select - Yes No
Please describe allergies:
Do you have a special diet? *
- Select - Yes No
Are you comfortable in a pet friendly home? *
- Select - Yes No
Do you observe any religious traditions in your home that you wish to disclose? *
- Select - Yes No
Would you be comfortable living in a home that observed religious traditions? *
- Select - Yes No
Would you prefer: *
- Select - with meals ($800.00/month) without meals ($575.00/month)
Why are you interested in taking part in the Homestay program? What do you hope to learn or gain from this program? *
Please provide your culinary likes and dislikes; also list any food allergies in this section as well:
How long are you planning to study at Lakehead University, English Language Centre? *
Do you have any accessibility or mobility issues you are comfortable disclosing? *
- Select - Yes No
If yes, please describe below: *
Do you have any medical issues issues you are comfortable disclosing? *
- Select - Yes No
If yes, please describe below: *
I am applying for homestay in: *
- Select - Thunder Bay Orillia