ALGOMA U HOMESTAY APPLICATION
1
PLEASE EMAIL THIS COMPLETED FORM TO HOMESTAY@ALGOMAU.CA
COST: $700/MONTH
APPLICATION FEE: $100
*FEES ARE SUBJECT TO CHANGE WITHOUT NOTICE*
Please attach your confirmed travel itinerary to this application to ensure your placement or
contact homestay@algomau.ca with your travel updates.
HOMESTAY PLACEMENTS WILL BE ISSUED UPON RECEIPT OF $2900 CAD, WHICH INCLUDES THE
FIRST 4 MONTHS OF HOMESTAY FEE ($2800 CAD) + HOMESTAY APPLICATION FEE ($100 CAD).
Please Note: If you are unable to pay the $2800 Homestay Fee (for 4 months) upfront, Interest
Charges will be applied to your outstanding account balance at the end of each month at an
annual rate of 5%
BEFORE ARRIVAL, A REFUND IS AVAILABLE ONLY IF THE APPLICANT PROVIDES PROOF OF
HAVING BEEN DENIED A VISA.
AFTER A STUDENT HAS MOVED INTO HOMESTAY, THE FIRST 3 MONTHS OF HOMESTAY FEE IS
NON-REFUNDABLE. THE 4TH MONTH OF HOMESTAY FEE IS REFUNDABLE ONLY IF THE
HOMESTAY COORDINATOR IS NOTIFIED BY THE STUDENT 4 WEEKS BEFORE MOVING OUT.
STUDENT INFORMATION:
Family name:
Nick Name (if applicable):
Home Address:
Home Phone:
Email (required):
Sex:  Female  Male
First & Middle Names:
Cell Phone:
Date of Birth: (day/month/year) ___/___/______
Current Age: ____________
WHAT TERM ARE YOU APPLYING FOR:
Fall (September-December)
Winter (January-April)
Spring/Summer (May-August)



YEAR: ___________
PERSON TO CONTACT IN CASE OF EMERGENCY:
Family name:
First & Middle Names:
Title:  Mrs.  Ms.  Mr.
Relation to the applicant (for example: father, sister):
Mailing Address:
Home Phone:
Cell Phone:
Email:
ALGOMA U HOMESTAY APPLICATION
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PERSONAL INFORMATION:
 Do you smoke?  Yes  No  Occasionally
If “no”, can you live with a family that smokes?  Yes  No
 Do you have a religion?  Yes  No
If yes, what is your religion (optional)?
 Would you like to attend church (if applicable)?  Yes  No
 Would you like to live in a house with children or do you prefer to live in a ‘quiet’ house? Please
explain:
__________________________________________________________________________________
__________________________________________________________________________________
 If you would like to live in a house with small children, do you mind spending time with them?
 Yes  No
In no, please state the reason why not:
__________________________________________________________________________________
 Would you feel comfortable living with another student of the opposite sex?  Yes  No
 Would you feel comfortable sharing a bathroom with a student of the opposite sex?  Yes  No
 Would you like to live with a family that has pets? (cats, dogs, etc.)  Yes  No
 If “no”, please state the reason why not:
__________________________________________________________________________________
 Do you have any allergies?  Yes  No
If “yes”, please specify your allergies (eg. food, animals, medication, etc.) which may affect your
Homestay:
__________________________________________________________________________________
 Do you have any medical or physical conditions that may affect your Homestay?  Yes  No
If “yes”, please explain & describe any medication that you may need (if applicable):
__________________________________________________________________________________
 Do you have dietary restrictions?  Yes  No
If “yes”, please describe:
__________________________________________________________________________________
__________________________________________________________________________________
 Describe what you typically eat for breakfast in your home country.
__________________________________________________________________________________
__________________________________________________________________________________
ACTIVITIES & INTERESTS:
How would you describe yourself as a person? Are you independent or dependent? Are you shy?
Quiet? Outgoing? Please tell us more about yourself to help us find a family that will be a good match
for you!
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
How long have you been studying English?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
ALGOMA U HOMESTAY APPLICATION
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Describe your ‘strength’ in the English language:
__________________________________________________________________________________
What is your weak area in English?
__________________________________________________________________________________
Have you ever traveled outside your home country?  Yes  No
If “yes”, describe where you traveled & for what reason.
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Have you ever stayed with another family when you have travelled in the past? What did you enjoy
about this experience? What was difficult for you?
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
PLEASE CHECK OFF ALL OF THE ACTIVITIES THAT YOU LIKE TO DO:
 Cinema/Movies
 Computers
 Cooking
 Drama/Theatre
 Drawing/Painting
 Listening to music
 Reading
 Watching TV
 Writing/Journalism
 Band
 Choir/Singing
 Guitar
 Piano
 Camping
 Hiking
 Aerobics
 Dance
 Soccer (Football)
 Track & Field
 Baseball/Softball
 Basketball
 Biking/Cycling
 Golf
 Horseback riding
 Martial arts
 Snowboarding
 Skiing (cross country)
 Skiing (downhill)
 Swimming
 Tennis
 Volleyball
 Ice hockey
 Wrestling
 Other: ________________
Describe what kinds of activities you would like to do as a student at Algoma University or in the
community of Sault Ste Marie (such as volunteer work, sports group, personal travel):
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Are there any comments or important information that you would like to add?
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
ALGOMA U HOMESTAY APPLICATION
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I understand that there is a non-refundable $2900 CAD payment required before I can be placed with a
Homestay family. I understand that this payment will be made to Algoma University and will be credited
towards the first four months of Homestay payment. I understand that the Homestay Fee is nonrefundable unless I am able to provide proof of having been denied a visa into Canada. I understand that
if I am not able to pay the full amount of $2800 CAD for the Homestay Fee upfront, Interest Charges will
be applied to my outstanding account balance at the end of each month at an annual rate of 5%.
I also agree to a minimum of a 3-month contract after which there must be a 4-week notice made in
advance to the Homestay Coordinator before moving out ( in this case, $700 for the 4th month will be
returned); otherwise, the full amount of $700 CAD will be charged for the 4th month.
Student Signature: _____________________________________________________________________
Date: _________________________________________________________________________________
If you want to pay the Homestay Fee with your credit card, please complete the following steps:
- Download the “Credit Card Authorization Form” attached and fill it out
- Fax it to AU: 1-705-949-6583
****** Please do not send your credit card information via email ******
If you want to transfer the Homestay Fee through your bank, please make it payable to:
Algoma University
1520 Queen Street East
Sault Ste. Marie, Ontario
Canada P6A 2G4
Electronic Banking Information:
Bank of Nova Scotia
20 Queen Street West, 4th Floor
Toronto, Ontario
Canada M5H 3R3
Canadian Clearing Code: CC000247696
Account Number: 409720039217
Swift Code: NOSCCATT
Please indicate clearly that your payment is for the Homestay Fee!
You may also contact accounts@algomau.ca for more payment options (draft, money order, etc.)