Homestay Booking Form
Student Details
Please complete with the Student's Details
Student Family Name
*
Student Given Name
*
Gender
Male
Female
Date of Birth
*
-
Day
-
Month
Year
Email address
*
Mobile Number/WhatsApp
*
Skype Name
Nationality
Language/s Spoken
Occupation
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Homestay Information
Please let us know how we can help you
Check in Date
*
-
Month
-
Day
Year
Check out Date
*
-
Month
-
Day
Year
Length of Stay (weeks + days)
*
Accommodation Type (please tick selected option)
*
Single Room (Over 18)
Single Room (with private bathroom)
Single Room (Under 18 - Guardianship)
Twin Share (Over 18 - Students travelling together)
Student Information
Please let us know your preferences
Do you accept a home with children?
Yes
No
If so, please specify preferred age
Any medical conditions?
If yes, please provide details
Do you have any dietary requirements?
Vegetarian
Vegan
No dairy
Gluten free
Other
Do you accept a family with pets?
Yes
No
If so, are there any pets you do not want to live with (i.e. no dogs)?
Do you smoke?
Yes
No
Hobbies & Interests
Special Requests
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Arrival and Departure Information
Arrival Date
*
-
Month
-
Day
Year
Arrival Time
*
Minutes
AM
PM
AM/PM Option
Flight Number
*
i.e. QF 180
Departure Date
-
Month
-
Day
Year
Departure Time
Minutes
AM
PM
AM/PM Option
Flight Number
i.e. QF 180
Airport Pick up and Drop Off
Airport Pick Up
Yes
No
Which Airport?
Airport Drop Off
Yes
No
Which Airport?
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