New Host Registration.

Name *

Address *

Suburb *

State *

Zip Code

Mobile Phone Number *

Email Address *

Female Parent Name / Birth Date / Occupation *

Female Parent WWCC or Blue Card Number and Expiry date. *

Male Parent Name / Birth Date / Occupation *

Male Parent WWCC or Blue Card Number and Expiry date. *

Children living with you now : Name / Gender/ Birth Date / Occupation. All Children residing in the home over 18 years of age require a WWCC Card or a Blue Card. *

Schools / Universities in your area *

Is Internet access available in the home *

Total number of student rooms available in your home *

Are your Student bedrooms inside your home or outside your home *

What Languages are spoken in the Home ? *

Is your home an Apartment or a House *

How is your home Heated ? *

Does your home have adequate Smoke Alarms ? *

Does your home have any extra security ? *

What are the Family interests *

What countries have you and/or your family travelled to in the past ? *

How many students have you had in the past ? *

Do you have any Pets *

Is your Home a non smoking home ? *

What is the Company name of your Home and Contents Insurance which covers student's Public Liability and Contents Insurance who are residing with you ? (Your Policy should say your insurance covers Unrelated Guests or Visitors) (Refer to http://www.homestay-australia.com/insurance1.htm ) *

What is the Expiry Date of the Insurance which covers students residing with you ? (Refer to http://www.homestay-australia.com/insurance1.htm ) *

Any International students residing in your home now. If yes, what are their ages and gender *

What Public Transport do you have available within walking distance of your home *

What is the travel time to the city from your home *

Which Meal service do you wish to Provide ? (Please tick multiple boxes) *

Do you prefer a Male or Female student ? *

Do you Agree with our Terms & Conditions. Refer to : http://www.homestay-australia.com/host_family_information.htm *