Application forms for accomodation in Brisbane

student application
host family application
additional documents for family application

Brisbane Student Application

Please complete and submit this application form.

Given Name Family Name
Your Nationality Date of Birth
Your Gender: Female Male  
Street Address City
Country Area / Zip / Post Code
Phone Number: Fax :
Email :    
Agency Name: Agency Branch:
Counsellor's Name: Counsellor's Email:
Do you smoke? yes no Will you live with a smoker? yes no
Do you like young children? yes no Do you like older children? yes no
Do you like animals? yes no Are you allergic to Animals? yes no
Do you have any special dietry requirements? Religion
(optional)
Do you have any illness?
Name of Educational Institution in Australia
Education Institution: Campus Name / Location or Campus Address
Accommodation required from (date) to
Is an airport pick up required? yes no
Flight No.
Airline
Time of Arrival
Tell me about yourself, your family and your interests
What kind of family would make you feel comfortable?
Type of accommodation required
Emergency Contact Details
Person in Australia
Name
Telephone
Email
Address
Person Overseas
Name
Telephone
Email
Address

Payment Options

printer Click here for a print version 

1. TELEGRAPHIC TRANSFER payable to AUZZIE FAMILIES Homestay Care Pty Ltd No2 A/C (Bank details upon application)

2. BANK DRAFT Payable to AUZZIE FAMILIES Homestay Care Pty Ltd No 2 A/C

3. TELEPHONE61 2 9301 0900 and quote your credit card details MasterCard / Bankcard / Visa

4. DIRECT CREDIT CARD CHARGE fill out the authority below and return it to our address (Note a 4.5% surcharge applies to all credit card transactions. Please add this amount to your total payment.)
CARD NUMBER................................................................................................
TYPE OF CARD MasterCard.........BANKCARD........VISA...................

SIGNATURE.....................................

NAME ON CARD..................................
EXPIRY DATE..................................

AMOUNT $..........................................

5. CHEQUE payable to AUZZIE FAMILIES Homestay Care Pty Ltd

Please print this page and fax to 61 2 9301 0999 or post to
AUZZIE FAMILIES Homestay Care Pty Ltd
PO Box 112 Rose Bay NSW 2029 Australia