Homestay Respite Request Form Respite homestay arrangements must be approved by the CVISP prior to commencement. Complete this respite request form a minimum of ten (10) business days in advance of the respite drop off date. A homestay coordinator will receive your request and email an approval or denial. Homestay Name* First Last Homestay Email* Drop off Date at Respite* Date Format: MM slash DD slash YYYY Pick up Date from Respite* Date Format: MM slash DD slash YYYY Number of Student(s) Requiring Respite*Select "One" or "Two"OneTwoStudent Name* First Last Student Name* First Last Have You Arranged a Respite Family?*Select "Arranged" or "ISP to Arrange"YesNo (Need ISP to Arrange)Respite Name* First Last Respite Phone*Respite Email* Respite Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Respite Home Payment Agreement*I agree to make payment of $30 per night ($60 for 2 students) of respite directly to the respite family at drop off of my student(s). I agree CommentsThis field is for validation purposes and should be left unchanged.