Damage Claim Form | West Vancouver Schools International

Host Family Name(Required)

Last

Date of incident/damage(Required)

Location of incident/damage(Required)

Time of incident/damage(Required)

Homestay Family Email(Required)

Reported/Submission Date(Required)

Host Family Address(Required)

Street Address Address Line 2 Postal Code

Name of Student(s) Involved(Required)

Please list all people present at the time of incident/damage(Required)

Please describe how the damage/incident occurred:(Required)

Please describe the measures taken:(Required)

Please describe the action desired as a result of this incident/damage:(Required)

Did you discuss damage with student?(Required)

Yes

If you have not please indicate why?

Has malicious damage or theft occurred?(Required)

Yes

Has accidental damage occurred?(Required)

Yes

Have you attached photos of the damage?(Required)

Yes

File

Accepted file types: jpg, png, Max. file size: 5 MB.