Application Form

Student Name (s) *

Student ID *

Answer every question please. If you are not sure just write NA. Thank you for visiting.

Period of Homestay Accommodation ? *

Are you seeking ? *

Single Room

Twin Share Room (Must be a couple or two friends together at the same time)

Meal Options *

No Meals Provided

Breakfast Only Provided

3 Meals per day x 7 days per week

2 Meals per day x 7 days per week

3 Meals per day (Weekends) & 2 Meals per day (Weekdays)

Shared Room - 3 Meals per day x 7 days per week

Shared Room - 3 Meals (Weekends) 2 Meals (Weekdays)

Shared Room - 2 Meals per day x 7 days per week

VIP Homestay Accommodation

Do you need Internet Access *

Nationality *

Birth Date *

Gender *

Male

Female

School / University *

School / University Address *

Course Start Date *

Student Email Address *

Agency Name *

Agent Email Address (If you have an Agent) *

Children *

With Children

Without Children

Do Not Care

Pets *

With Pets

Without Pets

Do Not Care

Do you have a Medical condition which may affect your living requirements ? *

Do you smoke ? *

Arrival Information

Is Airport Transfer required *

Arrival Date *

Arrival Time *

Name of Airline *

Flight Number *

Homestay Start Date *

Any Special Requests *

Dear Applicant
An Invoice will be sent to you for payment prior to providing your Accommodtaion profile. Please advise if you accept the Invoice and make payment or if you wish to change your Accommodation application or if you are no longer interested.

Do you Accept our Terms and Conditions ?

Refer to our website -

http://www.homestay-london.uk/pre_departure_information.htm *