Services
Included Homestay Services
Excluded Homestay Services
Cultural Concerns
Homestay Plans
Price List 2023
Health Care
Student Registration
Student Registration Form
Payment
Airport Service
Pickup Request
Cancellation Policy
Become a Host
Host Family Application
Do You Qualify?
Our Students
Conditions of Employment
Legal & Financial Obligations
Host Services
Meals
Our History
Contact Us
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Student Registration – Applying Process
Student Registration Form
Personal details
Family Name
Given Name
Gender
Male
Female
Birth date
Address
City, State/Province, Country
Zip/Postal Code
Phone Number Home
Phone Number Cell
Phone Number Work
Fax Number
E-mail address
Passport number
Country of issue
Canadian visa number
CAQ number
Name of Agency
Agency Email Address
Travel Details
Montreal Arrival date
Montreal Departure date
Homestay Start Date
Homestay End Date
Airport pick-up service
Yes
No
Airport drop-off service
Yes
No
Airline
Flight Number
Last airport before arrival
Other Information
Subject of study
School of study
Level of language study:
Beginner
Intermediate
Advanced
Do you smoke?
Yes
No
Do you have any physical handicaps?
Yes
No
If yes, Please specify
Can you live with cats?
Yes
No
Can you live with dogs?
Yes
No
Can you live with children?
Yes
No
Can you live with smokers?
Yes
No
What is your mother tongue?
Other Languages Spoken
Do you have any health problems?
Yes
No
If yes, Please specify
Are you taking any medication?
Yes
No
If yes, Please specify
Do you have health insurance?
Yes
No
Is it valid in Canada?
Yes
No
Company name and Policy #
Name of person to contact in an emergency
Phone number of person to contact in an emergency
What are your hobbies?
Special requirements?
Yes
No
If yes, Please specify
Accommodation
Accommodation Preference
Homestay (Private home)
Student residence
If possible, I prefer:
Regular HOMESTAY
Deluxe HOMESTAY (with private bath or en-suite)
If possible, I prefer:
ENGLISH speaking family
FRENCH speaking family
BILINGUAL (English & French) speaking family
If possible, I prefer:
FULL BOARD (3 meals)
HALF BOARD (2 meals)
HALF BOARD ON WEEKDAYS, FULL BOARD ON WEEKENDS (*Not available in Deluxe)
BED & BREAKFAST (Breakfast only)
ROOM RENTAL (No meals. *Not available in Deluxe)
If possible, I prefer:
ENGLISH residence
FRENCH residence
If possible, I prefer:
FULL BOARD (3 meals)
HALF BOARD (2 meals)
HALF BOARD ON WEEKDAYS, FULL BOARD ON WEEKENDS (*Not available in Deluxe)
BED & BREAKFAST (Breakfast only)
ROOM RENTAL (No meals. *Not available in French)
Payment
How will you pay?
Direct Deposit at the Royal Bank - in Canada only
cheque Canadian and U.S. citizens only
email bank transfer
international wire transfer
www.PayPal.com to info@minervahomestay.com (all credit cards accepted) Add 4%
I agree to the terms and conditions of homestay as outlined on the web site. I also agree to give one month's notice if I wish to end my homestay before the end date specified above.
Price Estimation
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$
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