Skip to: site menu | section menu | main content

WMV Homes

Currently viewing: WMV Homes » Application

Application

Please fill out the form below to the best of your ability. We will reply to your request within 48 hours. If you don't hear from us by then, please contact us.

 

Personal Information

When will you start school?  (MM/DD/YYYY)

Name of school:

Family Name:

First Name:

Middle Initial:

Present Address:

City:

Province/State:

Postal Code/Zip:

Country:

Nationality:

Phone:

Email Address:

Sex:

 Male   Female

Date of Birth: (MM/DD/YYYY)

Religion (for food arrangements)

 

School Information

Most recent school attended:

Degree or Diploma earned and field of study:

Are you currently a student?

 Yes   No

Occupation:

 

Family Information

Parent's address:

City:

Province/State:

Postal Code/Zip:

Country:

Phone:

Email Address:

Father's Name:

 

General Information

How did you learn about us?

How long do you plan to stay with us?

Interests/Hobbies/Sports:

Previous trips abroad:

Have you participated in a Homestay program before?

 Yes   No

Describe your personality (check all that apply):

 Outgoing Curious
Shy Independent
Energetic Sociable
Optimistic Cheerful
Serious Talkative
Tidy Adventurous
Outgoing Modest
Affectionate Quiet

Do you smoke?

 Yes   No

Pets?

 No dogs Dogs OK
No cats Cats OK

What do you hope to learn from your homestay?

Please introduce yourself briefly.

Please list any allergies (food, animal, plant), health problems, or dietary restrictions:

List the name of a person to contact in case of emergency.

First name

Last name

Address:

Phone:

By typing your name in the box below, you are signing this application and authorize WMV Homes to process and research all information provided.

Signature (type full name):

 

 

Back to top