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Application Form for Homestay or Shared House.
Answer every question please. If you are not sure just write NA.
Name (s)
*
Student ID (If applicable)
*
Mobile Number (Australian)
*
What Accommodation Type are you seeking?
*
Homestay With Meals provided
Shared House with Meals provided (You are over 18 years)
Shared House (No Meals provided)
Period of Accommodation?
*
Two Week Accommodation
Four Week Accommodation
Ten Weeks Accommodation
3 Months
6 Months
Are you seeking ?
*
Single Room
Twin Share Room - Must be a couple or two friends
Meal Options.
Costs will vary depending upon the Meals requested and the location of the accommodation.
*
No Meals Provided
3 Meals per day x 7 days per week
2 Meals per day x 7 days per week (Breakfast and Dinner)
3 Meals (Weekends) & 2 Meals (Weekdays)
Do you need Internet Access
*
Nationality
*
Birth Date
*
Gender
*
Male
Female
School / University
*
School / University Address
*
School Start Date
*
Email Address
*
Agency Name (If you have an Agent)
*
Agent Email Address (If you have an Agent)
*
Do you wish to live with Children
*
With Children
Without Children
Do Not Care
Do you wish to have Pets in the home
*
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
*
If Yes, Arrival Date
*
If Yes, Arrival Time
*
If Yes, Name of Airline
*
If Yes, Flight Number
*
Homestay Start Date
*
Any Special Requests
*
Do you Accept our Terms and Conditions ? (Refer to our website - Student Information / Predeparture information)
*