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FAMILY APPLICATION FORM -
KAMLOOPS
APPLICANT
First Name:
Last Name:
Occupation:
Gender:
Female
Male
SPOUSE
First Name:
Last Name:
Occupation:
Gender:
Female
Male
CONTACT INFORMATION
Address:
Postal Code:
City
Phone #:
Cell #:
Fax #:
e-mail:
Languages Spoken:
OTHER FAMILY MEMBERS
---
Name
Age
Gender
Relationship
1
SELECT
Female
Male
2
SELECT
Female
Male
3
SELECT
Female
Male
4
SELECT
Female
Male
FAMILY INFORMATION
Activities:
Hobbies:
Public transportation directions:
How many rooms do you have for hosting students?
YES
NO
Is this the first time you host students?
Do you host male students?
Do you host female students?
Do you host children?
Do you host students who smoke?
Do you have pets?
Do you work with other homestay companies?
Referral Program
Do you know another family who might be interested in supporting us?
---
Name
Phone #
1
2
3
