Family Homestay Registration

Please complete all fields. Use N/A if not applicable.

Family Details - Family Member 1





Home Business


Home Business


Family Details - Family Member 2





Home Business


Home Business


Home Address





General Information


Own Rent Other (Specify)







Yes No




Yes No

Children


Yes No

If yes, please complete below...

Name Date of Birth Gender
M F
M F
M F

Accommodation Details



Own Bathroom Share Bathroom
Own Toilet Share Toilet
Desk for study No desk for study
Internet access No internet access
Own phone line No phone line
Television No television
Sky TV No Sky TV

Student Preference


Male Female Either




Smoker Non Smoker

Comments


Referees


Name Phone
Name Phone

By submitting this form you are agreeing to the conditions for hosting International Students.