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Homestay Registration Form

In the following field please include contacts (including work if applicable) for mother, father.

Please include:

Mobile Numbers

Home Address

Email Address

In the following field please complete for each member of the family, including international students residing with you.




Working with Children (if over 18)



In the following field please complete for each member of the family: Pets in your home i.e. dog, cat, bird etc. and how many.  Are your pets kept inside or outside? 

Student preferences:  Please indicate if you prefer male, female or both. Please stipulate preferred age range of student.
Age: 15yrs+ 20yrs+ / 30yrs+  / No preference 
Length of stay: Short-term (within 1 month)  Long-term(over 3 months)   No preference 

Does your family eat a variety of foods, and if your student as special dietary requirements are you willing to cater for this? Could you describe what your family does and the weekend and do you encourage your student to participate in family activities?

Home Environment

In this section please describe your home i.e. how many bedrooms, bathrooms, living rooms etc. and how many bedrooms are available for students? Also please describe the student's bedroom. i.e. Room Size, single, double, wardrobe, own bathroom, bed size, study desk, raw space, study lamp, own TV.

Do you have a computer your student/s can use?  
Do you have WIFI system? 
Can he/she access the internet?  
*If Yes, do you charge for the internet?  If yes is there a charge per week for use of internet?
Can he/she use own laptop? 
What services/facilities are close to your home?(e.g. parks, shops, bus stop, banks, post office)


Please fill out as much information as you can. Thank you. 

Thanks for registering. We will be in touch shortyl.

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