Homestay Application Form

Homestay Application Form
Your Personal Details
Full Name*

Given Name(s)Family Name
Date of Birth*

DayMonthYear
Date
Gender*
Contact Number*
Please enter a valid phone number.
Email*
example@example.com
What is your Nationality?*
How long would you like the Homestay accommodation organised for?*
If you require longer than 3 months accommodation, please select the longest duration and advise our student support officer of the duration you require.
Intended start date for placement*

DayMonthYear
Date (DD/MM/YYYY)
Intended vacate date for placement*

DayMonthYear
Date (DD/MM/YYYY)
Briefly introduct yourself to your host family. The more informtion you can give us about what you life doing of school, the better we can match a host family to you and your interests.*

	Private Room	Shared Room
Traditional Homestay (2 meals - breakfast and dinner, Monday to Friday, 3 meals on weekends)
Complete Homestay (3 meals, 7 days per week)
Dinner Only (you will need to organise your own breakfast and lunch)
No Meals (You will need to organise all of your own meals)

Your Personal Details