Homestay Family Application Form

    Contact Information

    ※please be sure to input the phone number you can get.

    Family Information

    Family Member 01(Contact Person)

    ※Please input "-" if you input as manual.

    Family Member 02

    ※Please input "-" if you input as manual.

    Family Member 03

    ※Please input "-" if you input as manual.

    Family Member 04

    ※Please input "-" if you input as manual.

    Family Member 05

    Occupation

    ※Please input "-" if you input as manual.

    Some Question

    Confirmation

    I confirmed certify that above information is true and correct, and will inform Canada Japan Consulting Services Ltd. immediately if there are any changes.

    ※Please input "-" if you input as manual.