Homestay - Student Application

APPLICATIONSFOR THE UPCOMING SPRING / SU MMER 2013 TERM: 

Submission Deadline:

  • The Homestay Application deadline is March 15, 2013, by 4:30 pm (local Winnipeg time).
  • Late applications will still be accepted since there are  plenty of Homestay hosts available this Spring/Summer Term.
  • All ELC and Homestay Fees are due April 1, 2013.
  • Please submit all needed documentation and fees well before the deadline. View Homestay Deadlines.
  • Homestay applications that are not complete (eg. no student visa, arrival time or payment) at the time of the deadline will be placed on a waiting list for Homestay placement, and may not be eligible for a Homestay. 
  • Homestay applicants attending the ELC may pay their Homestay fees along with ELC tuition fees.

Availability & Coverage Period

  • Homestay placements will be available to begin April 28, 2013.
  • Students may not move into Homestay until April 28, 2013. Students who arrive before April 28, 2013 will be responsible for their own airport pickup and accomodation.  
  • Homestay applicants who are beginning a course of study at a time other than May 2013 should submit their Homestay application and fees at least one month prior to arrival.
  • The Homestay fees cover 4 months from the date of arrival.
  • Homestay placements are filled on a "first come, first served" basis and are subject to availability.
  • If all required documents and payment fees are submitted early, Homestay details will be provided sooner.
  • The Homestay program gives preference to new students.
  • Students must be 17 years of age or older to be eligible for the University of Manitoba English Language Centre Homestay Program.

 

IMPORTANT DATES TO CONSIDER

Placement Test Date: The English Language Centre placement test for new students will be held May 2, 2013.

ELC classes Start date is May 6, 2013.

 

Please CONTACT ME with any questions you might have.

Ann Friesen
Homestay Coordinator
University of Manitoba, English Language Centre
Enrolment Services
520 University Centre, Winnipeg, MB R3T 2N2
Tel: 204-474-6809
FAX: 204-275-8098
Emergencies Only: Tel: 204-228-2280
Email: homestay@umanitoba.ca

 

Contact Information (all fields are required to process application)

Family Name:

First Name:

English Name Used:

Student's Home Street Address:

City:

Country:

Postal Code/Zip Code :

Student's Home Telephone Number (with area or country code):

Fax Number (with area or country code):

Student Number:

Email:

Student's Email (if different from above):

Personal Information:

Male Female

Date of Birth -
Year: Month: Day:

Single Married Spouse name

Will spouse accompany you :

Which Languages Do You Speak?

If you have lived or traveled outside of your country before, please
describe where and for how long:

Do you live ? Do you live ?

List the names and ages of your brothers and sisters:
Name:
Age: Gender:

Name:
Age: Gender:

Name:
Age: Gender:

Please specify any allergies (eg. Food, pet animals, medication, etc.) that
may affect your Homestay:

Please describe any other medical and physical conditions which
may affect your Homestay:

Please indicate your level of English proficiency:

listening
speaking
reading
writing

 

Lifestyle

Please describe your hobbies and leisure activities. Please include as much detail as possible inorder to make the best possible match.:

Do you like outdoor activities?
Which ones do you like?

Do you like sports?
Which ones do you like?

Do you like the arts?
Which ones do you like?

Do you play a musical instrument?
If "yes" which one(s)?

Do you enjoy cooking?

If "yes" what do you like to cook?

Indicate the adjectives that best describe you:

shy and quiet adaptable and flexible independent
friendly and sociable neat and tidy studious
adventurous
Other

Are you a
Non-Smoker
Smoker
Would you accept a Homestay where you can only smoke outside? Yes No
Will you share a home with someone who smokes?

Would you like to live in a home with children? Yes No Maybe
If 'No' or 'Maybe', please describe your concerns:

Would you like to live in a home with pets? Yes No Maybe
If 'No' or 'Maybe', please describe your concerns:

Please tell us anything else about you that will help in placing you with a suitable family.

Describe your lifestyle. (ex: your personality, interests, and what you enjoy doing in your free time).

What are your hopes for your Homestay experience?

Dietary Requirements

Please describe the foods you are accustomed to eating:
Meat:
Never Sometimes Everyday
Vegetables:
Never Sometimes Everyday
Rice:
Never Sometimes Everyday
Pasta:
Never Sometimes Everyday
Fish:
Never Sometimes Everyday
Fruit:
Never Sometimes Everyday

Please describe any dietary restrictions:

Are you?
Vegetarian Vegan No pork diet (pig meat)

Comments Please describe any other concerns or questions which you have:

Study Program

English Language Centre
University of Manitoba Student (Undergraduate)
University of Manitoba Student (Graduate)
International College of Manitoba
Researcher
Visiting Scholar
Other

Term

Fall (September)
Winter (January)
Spring/Summer (May)

Visa Status

Student Visa/Permit
Visitors Visa
Visiting Scholar
Immigrant

Travel Information - NOTE: YOU MAY NOT MOVE IN TO HOMESTAY UNTIL APRIL 28, 2013.

1. Departure From Home

Date: Airline:

Time: Flight #:

2. Arriving in Winnipeg

Date: Airline:

Time: Flight #:

Port of Entry to Canada Toronto Vancouver
Other:

 

 

 

I understand that I will not be given a Homestay placement until I have provided my arrival information and paid $2,850.00 CDN ($2,900 for ICM students). These fees icludes a non-refundable, $150.00 application fee or $200.00 application fee for ICM students, a $100 administrative fee and $2,600.00 for the first 4 month's Homestay). Note: Effective September 2013, Homestay Fees total will increase to $3,150 CDN for ELC and UM students and $3,200 for ICM students. Fees are subject to change without notice.

I have:

read and understand the guidelines (see Internet/Computer Use Guidelines)
read and understand the Homestay Pledge
read and understand the written information provided, and agree to abide by the terms of that information

kept a copy of this application for my own records

understood that the Homestay program will not honour requests for host families that are racially discriminatory.

This information is being collected under the authority of The University of Manitoba Act. It will be used for the purpose of making a suitable match between student and family. Certain information will be shared with your Homestay family. It will not be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act. Your personal information is protected by the Protection of Privacy provisions of The Freedom of Information and Protection of Privacy Act. If you have any questions about the collection of your personal information, contact the FIPPA/PHIA Coordinator's Office, University of Manitoba Archives & Special Collections: Telephone: 204-474-8339 331 Dafoe Library Winnipeg, Manitoba Canada, R3T 2N2.

Date:

Please CONTACT ME with any questions you might have.

Ann Friesen
Homestay Coordinator
University of Manitoba, English Language Centre
Enrolment Services
520 University Centre, Winnipeg, MB R3T 2N2
Tel: 204-474-6809
FAX: 204-275-8098
Emergencies Only: Tel: 204-228-2280
Email: homestay@umanitoba.ca

Ann Friesen
Homestay Coordinator
Phone: 204-474-6809

Homestay Assistant
Phone: 204-474-8701