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Host Application Form

CONTACT DETAILS
Title Title
Your Surname Partner's Surname
Given Names Given Names
Date of Birth Date of Birth
Home Phone/ Fax No.    
Mobile Mobile
Work No. Work No.
Occupation Occupation
Email Email
Do you hold a current Child Suitability Card (Blue Card)?
Card No: Card No:
Exp Date: Exp Date:
Please send us a current copy of police checks and working with children checks to:
email to: info@homestaydirect.com.au or mail to level 6 suit 611, 343 Little Collins St Melbourne 3000
 
ACCOMMODATION DETAILS
No. & Street
Suburb / Post Code:
Description of Home
Description of Student's Room
Seporate Bathroom?
How many students can you accommodate?
(Students must have their own bedroom)
Does your family have any food restrictions?
What types of food does your family typically eat?
Can you accommodate vegetarians? Halal?
Pets?
Breed?
If Yes, are they outside only?
Is smoking permitted?
Do you have internet access which students can use?
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OTHER PERSONS IN HOUSEHOLD
Please list all of your children and any other persons who reside in your home
Relationship Name Age
*Please email the Blue Card details for all persons over the age of 18 living within your household.
   
STUDENT PREFERENCES
Gender
Age
Length of stay
Meals
Secondary or University School Students studying in Australia for approx 1-4 weeks only. Students are placed in pairs and require 3 meals and escorting to/from the city daily. Reimbursement at higher standard rate.
Are you interested in hosting Study tour students?
   
TRANSPORT DETAILS
Time to walk to closest tram/ bus stop / railway station to the city? (Minutes)
Travelling time to city?
Name & distance in metres/ time to closest train station:
Is private transport available if necessary?
Are you happy to disclose your address details to other homestay hosts for car-pooling purposes ?
ABOUT YOUR FAMILY
Are there any other languages spoken in your home?
Family activities & interests
Religion Affiliation?
Do you attend regular services?
Does your home & contents insurance include public liability cover (which covers boarders)?
How did you hear about our homestay programme?
Is there anything that you think we should know about your circumstances?
   
 

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