Homestay application

All information in this form will be used solely for the purpose of placing the candidate in a home, and will not be shared with any parties other than the homestay family on a necessary basis. The information in this form is confidential and will be treated as such except where needed. We will respect the client's privacy.

【Candidate】








Postal Code



Country Code

Available in Hawaii



【Homestay Programs】



Check-in

Check-out











【Reference Data】


We cannot promise that we will be able to accommodate requests besides those that are allergy-related. However, please note that all requests made in advance may not be fulfilled for certain.










※Host family preference









【Emergency Contact Information】





Purpose of Emergency Contact Information: Should there be an emergency, CPC will contact the person whose information is written under “Emergency Contact Information” above.
About payment:
* If you cancel 31 days before the check-in date or earlier, all expenses will be fully refunded.
* Should you decide to cancel within 30 days before the check-in date, the placement fee paid beforehand will be charged as a cancellation fee instead. All other fees will be refunded.
* You will need to pay a $200 security deposit by credit card when you check in. After you have checked out, if no damages have been made to the room we will refund the security deposit to your credit card.


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