Do you take daily medication? Yes No
If yes, please specify
Are you comfortable with children in the home between the ages of 12 years and under 13 years and over No children
Do you have any allergies? Yes No
If yes, please specify
Are you comfortable with pets in the home? Yes No
If no, please specify
(ILSC–Montréal only) Do you want your homestay family to speak
English French
Do you have medical insurance? Yes No
If yes, specify company What languages do you speak?
Do you smoke? Yes (Most families do not allow smoking indoors) No Are you comfortable with other students in the home? Yes No
Please note that students will speak a first language other than your own
Do you require a special diet? Yes No
If yes, specify
Interests and other comments
Requests are not guaranteed, but the Homestay staff at ILSC will do their best to accom