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Homestay Direct Student Application Form

Application form for Students seeking help with accommodation in Australia.

For more information about our services,please see http://www.homestaydirect.com.au

or email info@homestaydirect.com.au

Student's Full Name *
Preferred Name * The Name you would prefer to use while at your Homestay
Nationality *
School or University *
Gender *FemaleMale
Age * Student's age when completing this form
Email Address * This email address should be available to you when in Australia or at home if possible
Address in Home Country *
Home Phone * The phone number to contact those at your home address given above.
Student Mobile Phone * The mobile phone number you will be using in Australia.
Emergency Contact person in Australia * The person we should contact in an emergency
Phone number for Emergency Contact person *
Relationship to Student *
Arrival Date and Flight Number * These details are required even if you dont require airport pickup as we must inform your Homestay of your arrival time and date.
Airport Pick Up Required *YesNoUnsure
Name of Australian School you will attend *
School Attendance Start Date *
Accommodation Start Date *
Present English level *BeginnerIntermediateAdvanced
Do you prefer a family with children *No preferenceNo - I prefer to live with adults onlyYes - I prefer to live with adults and children
Are you willing to live with a family with pets *YesNoUnsure
Any Dietary Problems (if yes, please describe)
Do you take any medications (if yes, please describe)
Do you suffer from any allergies (if yes, please describe)
Do you smoke cigarettes *YesNo
Homestay Assistance required in which State Please add a $210.00AUD one of placement fee on top of the accomadation fee *NSWQLDVIC
Type of Board Required *NSW OR VIC - With Meals $225.00 AUD per weekNSW OR VIC - Without Meals $170.00 AUD per weekNSW OR VIC - Under 18 $240.00 AUD per week QLD - With Meals $200.00AUD per weekQLD - Without Meals $160.00 AUD per weekQLD - Under 18 $240.00 AUD per week
Initial Payment Required For International Transfers - An additional AUD$20.00 should be included to cover banking fees related to your payment. Account name: Homestay Direct Pty Ltd Bank name: Commonwealth Bank of Australia Branch: Queen Street, Melbourne BSB No: 063 003 Account No: 1012 4935 Swift Code: CTBAAU2S Payments by Credit Card - MASTERCARD and VISA Please contact our office on +61 3 9857 0507 with your Credit Card and we will process your payment over the telephone. Alternatively you may like to send a fax with the relevant details to +61 3 9857 0506.. * Payment of this amount includes Placement fee and first four weeks' accommodationNSW OR VIC - Under 18 $1170.00 AUDNSW OR VIC - Without Meals $890.00 AUDNSW OR VIC - With Meals $1110.00 AUDQLD - With Meals $1010.00 AUDQLD - Without Meals $850.00 AUDQLD - Under 18 $1170.00 AUD
Initial Payment will be made by * Please click on the Payment Methods for more informationBank Transfer Credit Card - MASTERCARD Credit Card - VISA Bank Cheque

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