Host Family Registration of Interest Form

Please complete this application, once submitted we will contact you as soon as possible.

First name:
Last Name:
Email Address:
Home Phone:
Mobile:
Fax:
Address:
Suburb:
Nationality:
Number of family members:
Ages of family members:
Ex. 52, 50, 25, 18
Description of Dwelling
Type of building:
How many bedrooms?
How many bathrooms?
Swimming pool? Yes
No
Games room? Yes
No
Other feature?
Could you host more than one student at a time? Yes
No
How far is your house from
public transport by foot?		 minutes
Does anyone in the house smoke? Yes
No
May the students smoke? Yes
No
If yes... Inside OK
Ouside Only OK
Any place is OK
Do you have pets? No
Yes (Dog, Cat, Croc ?)
Police Clearance / Blue Card? No
Yes
Special interests
(hobbies, sports, etc...)
Have you hosted
homestays before?		 No
Yes
If Yes, what nationalities?
From when is (are) your
room(s) available?
(dd/mm/yyyy)
Ex: 19/01/1987
Do you have any preferences or reservations about race, nationality, religion,
gender or age?
Thank you for completing this application. Please be assured the your information will be kept in the strictest confidence and not be use for any other purpose than matching you to home stay students

 

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