<p> STUDENT EVALUATION OF HOST FAMILY (Confidential)</p><p>DIRECTIONS TO STUDENT: Please complete and return this form, along with your completed Moving Notification / Intent to Return Form to the Centre for International Education, Building 255, Main Reception, at Vancouver Island University.</p><p>Today’s date: Date of move from host family: Student name: Student number: Host Name: Student E-mail address: </p><p>1) Do you think this family should host another international student? Yes □ No □</p><p>Would you recommend this host family to another international student? Yes □ No □ If you answered “No,” please explain why you feel this host should not have another student.</p><p>2) What activities did you do with the host family?</p><p>3) Was your room satisfactory? Yes □ No □ If you answered “No,” please explain what you did not like about your room.</p><p>4) Did you enjoy your meals in your Homestay? Yes □ No □ (Not applicable □) If you answered “No,” please explain what you did not like about the food.</p><p>5) Were you able to study quietly at your host’s home? Yes □ No □ If you answered “No,” please explain why you had problems studying.</p><p>©Vancouver Island University 2013 D:\Docs\2017-12-14\00d3597cbd6555ce507bd0a083ad64cb.doc Long-term Student Evaluation of Host Page 2</p><p>Student name: Student number: Host Name: Student E-mail address: </p><p>6) Were you often left alone without any family members at home? Yes □ No □ If you answered “Yes,” please explain when you were left alone. </p><p>7) Do you have any additional comments about your host family or the VIU Homestay/Peerstay Program?</p><p>Your opinion is important. Thank you for completing this evaluation. This information will be kept private.</p><p> Please allow three to four weeks from the date of your move for VIU to process and return your Deposit. </p><p> Deposit cheques can be picked up at Reception Desk in Building 255, at the Centre for International Education, Vancouver Island University.</p>