Farm/Ranch Host Application Form

Primary Contact Information

Applicant's Last Name*

Applicant's First Name*

Home Phone

Cell Phone*

General Contact/Mailing Information

Main Email*

Alternate Email

Alternate Cell Phone

Work Phone

Street Name and Number*

City*

Province*

Postal Code*

Skype/Google Hangout/Other

Preferred Contact Method*

Host Family Members

Applicant's 1st Name*

Birth Date (1)*

Relationship (1)*

Occupation (1)*

First Name (2)

Birth Date (2)

Relationship (2)

Occupation (2)

First Name (3)

Birth Date (3)

Relationship (3)

Occupation (3)

First Name (4)

Birth Date (4)

Relationship (4)

Occupation (4)

First Name (5)

Birth Date (5)

Relationship (5)

Occupation (5)

First Name (6)

Birth Date (6)

Relationship (6)

Occupation (6)

Hosting Preferences

Participant age preference*

Or: Only Within This Age Range (Specify)

Will You Host a Smoker?*

What Participant Gender(s) Can You Host?*

Can You Host Family Groups ?*

Other Comments

Describe your home

Home Type*

Total # bedrooms for volunteers*

How far is the Nearest City/Town?*

Specify city/town name*

Is volunteer's room*

Is volunteer's room in:*

Please Choose All That Apply (Keep CTRL Keyboard Button Pressed to Select Multiple Options)*

Other Information

Do You Have Any indoor Pets?*

Type of Pets:*

Does Anyone in Your Home Smoke?*

List Your Favorite Activities, Hobbies & Interests:*

List Language(s) Spoken In Your Home*

Have You Ever Hosted An International Volunteer Before?*

If Yes:

a) Since What Year?

b) For How Many Years (Cumulatively)?

c) From What Country(ies)?

d) From What Agency(ies)?

Can You Accommodate Participants with Special Diet (e.g. Kosher, Halal, Vegetarian, Allergies)?*

How large is your property (acres):

Please describe some of the chores and responsibilities your volunteer would be doing:

CRC - Criminal Record Check

Do You Have a Current CRC?*

If Yes, When Was This Done?

Do All Other Family Members 18 Years and Older Also Have a Current CRC?*

If Yes, When Was This Done?

Availability

Do you currently have availability to host a volunteer?*

Please specify the months of the year you are generally available to host:

Are you currently hosting any other volunteer?

If yes, from what country(ies)?

If you have room(s) becoming available in the near future, please specify date(s)

Referral

How did you find out about Home-Sweet-Homestay Canada?*

Notes

Please Add Any Comments About Your Ranch/Farm That You Think Would Be Important For Participants/HSH to Know