FALL 2018 STUDENT PROFILE

IMPORTANT REMINDERS FOR STUDENT APPLICANTS To complete your application, send the following to homestay@viu.ca 6 weeks in advance of the requested move in date: Completed Student Profile Signed Letter of Agreement Homestay Fee Payment Student Arrival Information

Students will be matched with a host upon submitting the completed student profile, signed letter of agreement and applicable homestay fees. Students will receive Host Family information three weeks (15 business days) before the Homestay Move-in Date.Request for extension of homestay dates needs to be submitted to the homestay office at least 30 days before scheduled move-out date.

English Language Centre Program

Fall Semester 2018 Fall Semester 2018 Term BAcademic Year 2018-2019

Fall Semester 2018 Academic Year 2018-2019

Move in: August 26, 2018 Move in: October 14, 2018Move in: August 26, 2018

Move out: December 2, 2018 Move out: December 2, 2018Move out: May 2, 2019

Homestay ($850/month or $29/day) Host provides food for 3 meals per day

Homestay Without Meals ($500/month or $17/day) Students are responsible for their own food: shopping, cooking and clean-up

MOVE-IN DATE AUGUST 26, 2018: Further details will be provided. Early move-ins are not possible. If you are planning to arrive in Nanaimo before this date, please email homestay@viu.ca for information regarding pick up and accommodation options.

Please complete this section if you are applying with the help of an agent, institution or family member. When possible, all correspondence from the Homestay Office will be sent to both the contact listed below and the student.

Email: Name of Contact:

Agency/Institution:

First/Given Name:

Date of Birth:

Female Male

Country: Postal Code:

Student Email:

ACCOMMODATION CHOICE:

Last/Family/Surname:

English Name/Nickname (optional):

Nationality:

Street Address:

City:

Telephone Number:

Academic and Graduate Programs

Move in: August 26, 2018Move in: August 26, 2018

Move out: December 21, 2018 Move out: May 2, 2019

SELECT PROGRAM AND SEMESTER:

EMERGENCY CONTACT - must be completed Provide the names of two people who live at different addresses

FAMILY CONTACT SECONDARY CONTACT

Name: Name:

Address: Address:

City: City:

Country: Country:

Telephone: Telephone:

Email: Email:

Relationship to you: Relationship to you:

STUDENT NAME: AGE: EMAIL:

TELL US ABOUT YOURSELF: What was your main activity during the past year?

attended high school attended college/university working

Canadian province: another country:

Yes No

Where were you living last year? country of citizenship

Have you ever lived on your own?

If yes, when, where, and for how long?

What are your hobbies and interests?

Yes No

How many hours per week do you plan to spend with your host family?

What activities would you like to do with your host family (ie. play sports, watch movies)?

Yes No *Use of the family computer will be limited.

Yes

Yes Doesn’t matter

Yes No A little

*In the homestay program, food for breakfast, lunch and dinner is provided by the host. Students will be taught to prepare their own breakfastand lunch. Please try to be open to new food experiences as Canadian meals may be different than what you usually eat.

Food Like OK Dislike Meat (pork, beef, lamb, etc.) Fish/seafood Poultry (chicken, turkey, etc.) Eggs Vegetables Dairy (milk, cheese, yogurt, etc.) Fruit Sandwiches Beans/lentils Other:

Comments

No

Will you bring your own computer/laptop?

Do you smoke?

Would you live with someone who smokes?

Do you like dogs? Yes No

FOOD:

Are you able to cook?

Do you require a special diet (for example vegetarian, vegan, religious dietary needs)?

Please indicate your food likes/dislikes below:

No *Canadian families do not allow smoking inside their homes.

Do you like cats?

ALLERGIES/SPECIAL CONDITIONS: If you require medication or are on a medically prescribed diet, you MUST bring a letter from your doctor, written in English. The letter should explain the condition, the medication you require and any special considerations, such as foods you must not eat. You may also be asked to provide a letter from your doctor regarding other conditions and/or allergies. * All students must have medical insurance while in Canada.

Do you have food allergies? Yes No

List the specific food(s) and the effect(s) of the allergy:

List any medication taken to treat the allergy:

Do you have any other allergies (for example, medicines, plants or pets)? Yes No

Name the allergy source and its effect(s):

sociable independent energetic shy

talkative adapt easily adventurous quiet

family with teenagers (age 12-19)

adult(s) without children

other, describe (artistic, musical, etc.):

family with young children (age 0-11)

family hosting another international student

adult(s) with adult children no preferences

none survival beginner intermediate advanced

Additional comments/information:

Student Signature Date

Signature of Parent/Guardian (Required if applicant is under 19 years of age)

Date

List any medication taken to treat the allergy:

Do you have any other special physical needs?

Refer to the following link for the English Language Program test: international.viu.ca/english-language-centre/basic-english-entry-test

We will select a host family based on the information you have provided. While we do our best to accommodate student preferences whenever possible, we cannot guarantee that all of your preferences will be met.

Please acknowledge that you understand and agree with the information contained on this form by signing/typing your full name below. Vancouver Island University may release information on this application, as well as any follow-up information and/or amendments applicable to homestay/peerstay, to your host family.

YOUR CHARACTER:

(check all that apply)

YOUR PREFERENCES:

(check all that apply)

YOUR ENGLISH LEVEL:

Dear student,

It is very important that you know our program’s policies, rules and expectations. You must also understand your

role, rights and responsibilities as a student. Please read our Handbook for International Students, available on our

website: https://international.viu.ca/sites/default/files/student-handbook.pdf, and complete the information

below.

I have read the Handbook for International Students, posted on the VIU Homestay website, and I fully understand

my role, rights and responsibilities as a student.

Student Signature Date

I had help with the translation of the Handbook for International Students:

Yes No

Full Name of Translator (if applicable)

HOMESTAY STUDENT LETTER OF AGREEMENT

The WorldVIU Homestay Program is designed to promote friendship and language learning, and to provide an opportunity for cultural exchange between Canadian families and the international students who attend Vancouver Island University (VIU). This letter sets out the terms and conditions to which you are agreeing and the financial arrangements for your participation as a student in the Homestay Program.

While you are in VIU Homestay, expect to be treated with respect by your hosts. Equally, you must treat your host(s) with respect.

AS A STUDENT IN HOMESTAY, I UNDERSTAND THAT AND/OR AGREE TO: 1. I may not participate in the Homestay Program unless (i) I am currently enrolled as a full-time international

student in good standing at VIU as determined by VIU; (ii) I have paid the deposits and all fees then due andpayable as required; (iii) I have agreed to the terms and conditions of this Agreement by completing the VIUHomestay profile and letter of agreement; and (iii) VIU has designated a homestay for me. I must maintain myfull-time student status to remain eligible to reside in VIU Homestay, and I agree to notify VIU Homestaypromptly if there are any changes that would affect my eligibility.

Deposit and Fees 2. I have paid $1700 in advance for homestay fees to the Homestay Office. The Homestay Office will pay fees

directly to the host family on my behalf until the $1700 has been paid out. I (the student) will be responsible forpaying fees thereafter, as per the Fee Schedule provided by the Homestay Office. I understand that an email willbe sent to me regarding my Fee Schedule (payments).

3. I will pay the homestay fee to my host family on the first day of each month, and for any additional nights that Istay with my host family according to the current fees structure.

4. The refundable deposit may not be returned in full, if (but not limited to): I have not given 30 days’ notice inwriting (Moving Notification Form), or there are cleaning costs or damages in the home as a result of myconduct. Other outstanding bills, VIU tuition or VIU fees owing may also be deducted from my homestay depositand may delay the homestay deposit refund.

5. Homestay deposits must be requested in writing (Moving Notification Form) no longer than 36 months after mylast day of registered classes at Vancouver Island University.

Cancellation and Refunds 6. If I cancel my application with the VIU Homestay Program due to a legitimate and documented visa refusal

within 10 calendar days of the original move-in date, I will be charged a $100 cancellation fee (documentverification required). If I cancel my VIU Homestay application within 10 calendar days of the original expectedmove-in date, and visa refusal is NOT the reason for cancellation, I will be charged a $200 cancellation fee.

7. If my visa is denied, I can request to have my Homestay fees refunded (excluding application fee andcancellation fee).

8. If I have applied to the Homestay Program at VIU but am unable to attend, I can defer the application to thefollowing term.

9. If I have been placed with a host family and delay my arrival date with less than 10 calendar days' notice, thehost family may be paid from the original arrival date.

10. The Homestay application fee is non-refundable.

Termination of Homestay and Changing Homestays 11. I will consult the HS Manager or Coordinator before I make a decision to move out of homestay.12. I agree to give a minimum of 30 days’ written notice with a Moving Notification Form before moving from my

homestay. Notice can be given on any day of the month. Example: A student, who completes a MovingNotification Form with her host family on May 23 is responsible for homestay fees until June 21 (30 days later).

13. After I have given my homestay family 30 days’ notice, I agree to pay my homestay fees for the following 30days regardless of whether I stay in the homestay for the full 30 days, or not.

14. When it is not possible to resolve a problem, the Homestay Manager or Coordinator will move me as soon aspossible. The Homestay Manager or Coordinator will determine the payment owed.

15. Lack of 30 days’ notice will mean less than a full return of my homestay deposit.16. I will conduct myself with appropriate behavior in homestay. Inappropriate behaviours in homestay include (but

are not limited to) the use or possession of illegal drugs or paraphernalia, sexual relations, intoxication, theft,racism, or willful property damage. Such conduct is prohibited and is grounds for immediate removal from theVIU Homestay Program. Refer to the VIU Student Code of Conduct website for more information.

17. I am responsible to pay the balance of the 30 days' notice to my host family if my conduct is the reason forremoval from VIU classes or expulsion from VIU.

Role of the Emergency Contact and Protection of Privacy 18. As part of the VIU Homestay application process, I am required to identify emergency contacts. I understand it is

strongly recommended that these contacts be my parents or legal guardians. VIU may contact the emergencycontacts at any time and for any purpose including, without limitation, to advise them of any accident or injuryto me, any situation where I may cause harm to myself or to another person, or any default by me under thisAgreement. VIU may disclose my personal information in communications with my emergency contacts and Ihereby consent to this disclosure.

19. In the event that there is a concern for risk of safety to me or others, VIU Homestay staff may share informationwith another VIU host family in order to place me in an appropriate accommodation. This is in accordance withFreedom of Information and Protection of Privacy guidelines.

20. Freedom of Information and Protection of Privacy. Personal information about me in the possession of VIU isbound by the British Columbia Freedom of Information and Protection of Privacy Act and will not be released topersons outside VIU administration, including parents or guardians, family members or friends, without mywritten consent, unless permitted or required by law.

Matching 21. The Homestay (HS) Manager or Coordinator will select a host for me from those available, based on the

information I have provided. I understand that Vancouver Island University cannot guarantee that all mypersonal preferences will be met.

22. I understand that students will be matched only when the completed student profile and applicablehomestay fees have been submitted. I will receive Host Family Information no earlier than three weeks(15 business days) before the designated Homestay Move-in Date.

Student Responsibilities – I will: 23. Be responsible for all telephone expenses, including long distance charges and taxes. I will use a long distance

telephone card if I use my host family’s telephone. I will ask permission to make long distance calls on my hostfamily’s phone before I use it. Mobile phone purchases and contracts are my sole responsibility.

24. Not engage in, nor sign any contracts with my host that would incur any financial obligation or responsibility foreither party. For example: bank account, mobile phone, rentals, or purchases of any kind.

25. Become familiar with and understand the routines of my homestay family and follow those routines.26. Discuss with my hosts any of my special requirements, preferences and interests, so they can understand what I

will need to feel comfortable.27. Always tell my hosts if I will be away overnight, and leave a telephone number where I can be contacted.28. Always tell my hosts if I will not be home for the evening meal, or if I will be arriving home late in the evening.29. Ask my hosts’ permission before inviting guests to the home.30. Purchase my own toiletries and personal items.31. Clean my own room and change the bed sheets. Clean the bathroom after I use it. Help my hosts clean the

dishes after meals. Be prepared to do my own laundry, make my own breakfast and lunch, and assist inhousehold duties as other family members do.

32. Arrange for personal insurance for my possessions. Neither Vancouver Island University nor the hosts will beresponsible for the replacement of my possessions that are lost or damaged.

33. Speak to the Homestay Manager or Coordinator if I have a problem with my host family. The Manager orCoordinator will help me talk to my hosts about the problem. Because Canadian customs are different fromcustoms in my country, my hosts may not know that I am feeling uncomfortable. Problems can be solved only ifthe hosts know about them.

I understand and agree to the terms and conditions of items 1 through 33 of this Homestay Student Letter of Agreement.

Student Signature Date

Signature of Parent or Guardian (Required if applicant is under 19 years of age) Date

Signature of Agent/Person Assisting Student with Application Date

HOMESTAY WITHOUT MEALS STUDENT LETTER OF AGREEMENT

The WorldVIU Homestay Program is designed to promote friendship and language learning, and to provide an opportunity for cultural exchange between Canadian families and the international students who attend Vancouver Island University (VIU). This letter sets out the terms and conditions to which you are agreeing and the financial arrangements for your participation as a student in the Homestay Program.

While you are in VIU Homestay, expect to be treated with respect by your hosts. Equally, you must treat your host(s) with respect.

AS A STUDENT IN HOMESTAY, I UNDERSTAND THAT AND/OR AGREE TO: 1. I may not participate in the Homestay Program unless (i) I am currently enrolled as a full-time international

student in good standing at VIU as determined by VIU; (ii) I have paid the deposits and all fees then due andpayable as required; (iii) I have agreed to the terms and conditions of this Agreement by completing the VIUHomestay profile and letter of agreement; and (iii) VIU has designated a homestay for me. I must maintain myfull-time student status to remain eligible to reside in VIU Homestay, and I agree to notify VIU Homestaypromptly if there are any changes that would affect my eligibility.

Deposit and Fees 2. I have paid $1000 in advance for homestay fees to the Homestay Office. The Homestay Office will pay fees

directly to the host family on my behalf until the $1700 has been paid out. I (the student) will be responsible forpaying fees thereafter, as per the Fee Schedule provided by the Homestay Office. An email will be sent to youregarding your Fee Schedule (payments).

3. I will pay the homestay fee to my host family on the first day of each month, and for any additional nights that Istay with my host family according to the current fees structure.

4. The refundable deposit may not be returned in full, if (but not limited to): I have not given 30 days’ notice inwriting (Moving Notification Form), or there are cleaning costs or damages in the home as a result of myconduct. Other outstanding bills, VIU tuition or VIU fees owing may also be deducted from my homestay depositand may delay the homestay deposit refund.

5. Homestay deposits must be requested in writing (Moving Notification Form) no longer than 36 months after mylast day of registered classes at Vancouver Island University.

Cancellation and Refunds 6. If I cancel my application with the VIU Homestay Program due to a legitimate and documented visa refusal

within 10 calendar days of the original move-in date, I will be charged a $100 cancellation fee (documentverification required). If I cancel my VIU Homestay application within 10 calendar days of the original expectedmove-in date, and visa refusal is NOT the reason for cancellation, I will be charged a $200 cancellation fee.

7. If my visa is denied, I can request to have my Homestay fees refunded (excluding application fee andcancellation fee).

8. If I have applied to the Homestay Program at VIU but am unable to attend, I can defer the application to thefollowing term.

9. If I have been placed with a host family and delay my arrival date with less than 10 calendar days' notice, thehost family may be paid from the original arrival date.

10. The Homestay application fee is non-refundable.

Termination of Homestay and Changing Homestays 11. I will consult the HS Manager or Coordinator before I make a decision to move out of homestay.12. I agree to give a minimum of 30 days’ written notice with a Moving Notification Form before moving from my

homestay. Notice can be given on any day of the month. Example: A student, who completes a MovingNotification Form with her host family on May 23 is responsible for homestay fees until June 21 (30 days later).

13. After I have given my homestay family 30 days’ notice, I agree to pay my homestay fees for the following 30days regardless of whether I stay in the homestay for the full 30 days, or not.

14. When it is not possible to resolve a problem, the Homestay Manager or Coordinator will move me as soon aspossible. The Homestay Manager or Coordinator will determine the payment owed.

15. Lack of 30 days’ notice will mean less than a full return of my homestay deposit.16. I will conduct myself with appropriate behavior in homestay. Inappropriate behaviours in homestay include (but

are not limited to) the use or possession of illegal drugs or paraphernalia, sexual relations, intoxication, theft,racism, or willful property damage. Such conduct is prohibited and is grounds for immediate removal from theVIU Homestay Program. Refer to the VIU Student Code of Conduct website for more information.

17. I am responsible to pay the balance of the 30 days' notice to my host family if my conduct is the reason forremoval from VIU classes or expulsion from VIU.

Role of the Emergency Contact and Protection of Privacy 18. As part of the VIU Homestay application process, I am required to identify emergency contacts. I understand it is

strongly recommended that these contacts be my parents or legal guardians. VIU may contact the emergencycontacts at any time and for any purpose including, without limitation, to advise them of any accident or injuryto me, any situation where I may cause harm to myself or to another person, or any default by me under thisAgreement. VIU may disclose my personal information in communications with my emergency contacts and Ihereby consent to this disclosure.

19. In the event that there is a concern for risk of safety to me or others, VIU Homestay staff may share informationwith another VIU host family in order to place me in an appropriate accommodation. This is in accordance withFreedom of Information and Protection of Privacy guidelines.

20. Freedom of Information and Protection of Privacy. Personal information about me in the possession of VIU isbound by the British Columbia Freedom of Information and Protection of Privacy Act and will not be released topersons outside VIU administration, including parents or guardians, family members or friends, without mywritten consent, unless permitted or required by law.

Matching 21. The Homestay (HS) Manager or Coordinator will select a host for me from those available, based on the

information I have provided. I understand that Vancouver Island University cannot guarantee that all mypersonal preferences will be met.

22. Students will be matched only when the completed student profile and applicable homestay fees havebeen submitted. Students will receive Host Family Information no earlier than three weeks (15 businessdays) before designated Homestay Move-in Date.

Student Responsibilities – I will: 1. Be responsible for all telephone expenses, including long distance charges and taxes. I will use a long distance

telephone card if I use my host family’s telephone. I will ask permission to make long distance calls on my hostfamily’s phone before I use it. Mobile phone purchases and contracts are my sole responsibility.

2. Not engage in, nor sign any contracts with my host that would incur any financial obligation or responsibility foreither party. For example: bank account, mobile phone, rentals, or purchases of any kind.

3. Become familiar with and understand the routines of my homestay family and follow those routines.4. Discuss with my hosts any of my special requirements, preferences and interests, so they can understand what I

will need to feel comfortable.5. Always tell my hosts if I will be away overnight, and leave a telephone number where I can be contacted.6. Always tell my hosts if I will not be home for the evening meal, or if I will be arriving home late in the evening.7. Ask my hosts’ permission before inviting guests to the home.8. Purchase my own toiletries and personal items.9. Clean my own room and change the bed sheets. Clean the bathroom after I use it. Help my hosts clean the

dishes after meals. Be prepared to do my own laundry, make my own breakfast and lunch, and assist inhousehold duties as other family members do.

10. Be responsible for the shopping, preparation and cooking of my own meals. I will discuss food preparation andcooking schedules with my host.

11. Be responsible for cleaning dishes, countertops and appliances, including the stove elements. I will discusscleaning expectations with my host.

12. Arrange for personal insurance for my possessions. Neither Vancouver Island University nor the hosts will beresponsible for the replacement of my possessions that are lost or damaged.

13. Speak to the Homestay Manager or Coordinator if I have a problem with my host family. The Manager orCoordinator will help me talk to my hosts about the problem. Because Canadian customs are different fromcustoms in my country, my hosts may not know that I am feeling uncomfortable. Problems can be solved only ifthe hosts know about them.

I understand and agree to the terms and conditions of items 1 through 35 of this Short-Term Students/Group Homestay Student Letter of Agreement

Student Signature Date

Signature of Parent or Guardian (Required if applicant is under 19 years of age) Date

Signature of Agent/Person Assisting Student with Application Date

FEE PAYMENT FORM

Email: homestay@viu.ca or Fax: 1-250-740-6471

Name of Student: Date of Birth: Female Male

Name of Sender/Agent:

Date Sent: Amount: $

METHOD OF PAYMENT Cheque (payable to Vancouver Island University) has been sent

Expiry date: MC/Visa/Amex No:

Cardholder Name:

I have wired fees to Vancouver Island University. *PIease email homestay@viu.ca for VIU banking information

$ 850.00

$ 250.00

$1,700.00

$2,800.00 (CDN)

$ 850.00

$ 250.00

$1,000.00

$2,100.00 (CDN)

WIRE TRANSFERS: Write student name and birth date on all financial transactions (i.e. cheques, money orders, bank transfers, and direct deposits).

Bank charges are the responsibility of the sender.

Deposit (refundable)

Placement Fee (non-refundable)

Homestay Fees (2 months @ $500/month) Payable to host as indicated on the match letter

Total Amount Homestay Without Meals:

HOMESTAY:

Deposit (refundable)

Placement Fee (non-refundable)

Homestay Fees (2 months @ $850/month) Payable to host as indicated on the match letter

Total Amount Homestay:

HOMESTAY Without Meals:

INTERNATIONAL STUDENT ARRIVAL INFORMATION Email: homestay@viu.ca or Fax: 250-740-6471

Please ensure that you have all the documents you need to enter Canada and study at VIU (for example study permit and/or visa). Students must inform the homestay office if their arrival may be delayed as it could affect placement and fees.

Name of Student: ______________________________________________________________ First/Given Name

Female Male

Last/Family/Surname

Date of Birth: ________________________________________

Arrival at VANCOUVER INTERNATIONAL AIRPORT: Date:

Airline:

Arrival Time:

Flight Number: *Host families pick students up at their point of arrival in Nanaimo only.

If you wish to be met at the Vancouver airport, please see Arrival Services below.

Arrival at NANAIMO AIRPORT: Date:

Airline:

Arrival Time:

Flight Number:

--Or-- Arrival at NANAIMO FERRY TERMINAL:

Horseshoe Bay to Departure Bay - Date: Arrival Time:

--Or--

Tsawwassen to Duke Point - Date: Arrival Time:

Arrival Services

If students do not have a connecting flight to Nanaimo Airport (YCD) from Vancouver International Airport (YVR) and would like assistance to any of the ferry services (BC Ferries), or harbour to harbour float planes, please contact Beaton's Meet and Greet. Beaton's will be happy to meet students at the exit of the arrivals area at YVR and transport the student to the ferry or float plane service. They will also help purchase a ticket from Vancouver to Nanaimo on behalf of the student. If applicable, Beaton's Meet and Greet will ensure that the Host Family is informed of the student's arrival time and that they will be present at the pick-up location.