What are your interests and hobbies? Please be as complete as possible.
At home, are you a student? Yes No
If yes, what program are you studying? How many years have you been studying in this program?
If no, what is your profession?
How would you rate your English proficiency? (e.g., beginner, intermediate, or advanced)
In speaking?
In writing?
In reading?
In listening?
Overall?
Have you travelled before? Yes No
If yes, where have you travelled?
Expected date of arrival in Halifax: __________________________________________________
Expected date of departure from Halifax: _____________________________________________
TERMS OF HOMESTAY
I will stay with my host family for a complete semester. I will pay my host family the full
semester's rent on arrival in Halifax. I agree to tell my host family 30 days before the day I
move. I understand that I may not move into my homestay until 9:00 am on the Saturday
before my first semester at The Language Centre begins. I understand that I must move out
of my homestay on the Saturday following the last day of The Language Centre semester. If
I arrive before that time, I will arrange my own temporary accommodation in a hotel or
hostel.
I have read and understand the terms of homestay above and agree to abide by these rules.
Signature:
Date: _________________________________
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