About Global Partners
Family Information
Home Address City
Province Postal Code Home Phone
Mother
First Name Last Name
Occupation Employer
Work Phone
Father
First Name Last Name
Occupation Employer
Work Phone
Please list all people living in home, including mother and father
Name Relationship Age Gender Interests
Please provide 2 references (not related to Host Family).
Name Address Phone

Do you know any other good families who might like to host?

Would your student share a room? Yes   No

If "YES", with whom?

Is smoking allowed in your home? Yes   No

Have you hosted before? Yes   No

Are you able to transport your student to and from the study centre, daily? Yes   No

By submitting this application, I agree to abide by Global Partners Institute's policy of one student per host family. Only in the case of a special request from the group organizer, or an emergency, does GPI allow 2 students to stay with the same family at the same time. We further agree to inform Global Partners Institute immediately in the event that any information on this application changes.
In the interests of student safety, we agree that GPI may request a police check be provided.