Host family application form

I would like to host a Katimavik volunteer in my home.

Please select your community from Katimavik’s 64 communities partners listed. Please note that communities are listed alphabetically by region (Atlantic-Quebec | Ontario | North, Pacific and Prairies).
Please select a community
*Salutation:  

*Name:

*Address:

*City/town:

*Province:

*Postal code:

*Telephone:
ex.: 555-555-5555

Email:

Comments:

* denotes required field
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