Student Application Form for Homestay Accommodation

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 ? *

Two Week Homestay

Five Week Homestay

10 Weeks Homestay

12 Month Homestay

Are you seeking ? *

Single Room

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

Meal Options *

No Meals Provided (Single Room)

Breakfast Only Provided (Single Room)

3 Meals per day x 7 days per week (Single Room)

2 Meals per day x 7 days per week (Single Room) (Breakfast and Dinner)

3 Meals (Weekends) & 2 Meals (Weekdays) (Single Room)

VIP Homestay Accommodation (Single Room)

Do you need Internet Access *

Nationality *

Birth Date *

Gender *

Male

Female

School / University *

School / University Address *

Start Date *

Student Email Address *

Agency Name (If you have an Agent) *

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 *

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) *