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Application Form
Student Name (s)
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Student ID
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Answer every question please. If you are not sure just write NA. Thank you for visiting.
Period of Homestay Accommodation ?
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Two Week Homestay
Four Week Homestay
Five Weeks Homestay
Weekend Homestay
Are you seeking ?
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Single Room
Twin Share Room (Must be a couple or two friends together at the same time)
Meal Options
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Accommodation for Chores (Single Room)
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)
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 (Shared Room)
VIP Homestay Accommodation (Single Room)
Do you need Internet Access
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Nationality
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Birth Date
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Gender
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Male
Female
School / University
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School / University Address
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Course Start Date
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Student Email Address
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Agency Name
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Agent Email Address (If you have an Agent)
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Children
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With Children
Without Children
Do Not Care
Pets
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With Pets
Without Pets
Do Not Care
Do you have a Medical condition which may affect your living requirements ?
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Do you smoke ?
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Arrival Information
Is Airport Transfer required
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Arrival Date
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Arrival Time
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Name of Airline
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Flight Number
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Homestay Start Date
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Any Special Requests
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Do you Accept our Terms and Conditions ? (Refer to our website - Student Information / Predeparture information)
*