Brisbane Student/Visitor Application

Personal Details
  1. (required)
  2. (required)
  3. (required)
  4. (required)
  5. Gender
  6. (valid email required)
  7. (valid email required)
  8. Do you smoke?
  9. Will you live with a smoker?
  10. Do you like young children?
  11. Do you like older children?
  12. Do you like animals?
  13. Are you allergic to Animals?
Course Details
  1. (required)
  2. (required)
Accomodation and Travel
  1. Is an airport pick up required?
Emergency Contact Details
  1. Person in Australia
  2. (valid email required)
  3. Overseas Parent or Carer
  4. (required)
  5. (required)
  6. (required)
  7. (valid email required)
Accept Terms
  1. Student requests are seriously considered but it may be not be possible to meet all requests. Additional requests cannot be considered after placement confirmation or additional charges apply.
  2. Do you agree to abide by Australia’s Anti-Discrimination Law and Privacy Law. Please see below*.
  3. Have you read and agreed to the Auzzie Families Tariffs, Terms and Conditions. Please see below*.
 

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Insurance: This is a policy we recommend for travellers not on student visas:
www.educare-world.com

Please read the following terms and conditions

Australia’s Anti-Discrimination and Privacy Laws
Australia’s Anti-Discrimination Law
http://www.lawlink.nsw.gov.au/adb
and Privacy Law http://www.privacy.gov.au

Aussie Families Tariffs, Terms and Conditions
Brisbane Student Tariffs, Terms and Conditions

Payment Options

 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