HOST APPLICATION - Auzzie Families Homestay Care

HOST APPLICATION - Auzzie Families Homestay care

Host Application

PLEASE COMPLETE THE FORM PROVIDING AS MUCH INFORMATION AS POSSIBLE

*If you are running a family Day Care Centre registered or private please contact our office prior to completing the online application.

Location *

Accommodation Type

Title*

First Name*

Surname*

Preferred Name

Status

Date of Birth*

Occupation*

Home Phone

Mobile Phone

E-mail Address*

Main Language Spoken at Home

Religion

Smoker

WWCC/BC No (If known)

Issue Date

Expiry Date

Residency Status

Address Details

Street Address *

Suburb *

State *

Post Code *

Hosting Information

Gender Preference

Age Preference

Do you need the student to do their laundry? *

Do you need the student to do household chores? *

Home Details

Home Type

Home Condition is

Ownership Status

Total Bedrooms

Total Bedrooms available to Student

Total Bathrooms

Total Bathrooms Available to Student

Other facilities available

Please describe your home

Please describe the main public transport available from your home

Please describe you and your family

Home Content Insurance

Do you have Home Content Insurance?

Public Liability Insurance

Do you have Public Liability Insurance?

Family Members

Firstname	Lastname	Relationship	Gender	Occupation	DOB If 18 and over, contact & WWCC details required	Contact Email	Contact Phone	WWCC	WWCC Expiry Date

Pet Details

If you don't have any pets, you can leave the section blank.

Type of Pet	Breed	Location	Name

Student Room Details

Room no *	Size *	Bed Size	Bathroom	Occupied	Available date	Room facilities

Declaration

1 . I/We understand the responsibilities and requirements of hosting an international student.

2 . I/We understand that Auzzie Familes Homestay Care attempts to select bona fide students and cannot be held responsible for any undesirable or negligent actions of the student.

3 . I/we approve Auzzie Families Homestay Care to collect, hold & work with my personal records solely for the purpose of conducting homestay agency duties. By providing Auzzie Families Homestay Care with your personal information you consent to us collecting, disclosing, storing & using it in accordance with our Privacy Policy. You have obtained prior consent to supply personal information of any other household members.

4 . We certify the answers given are true and correct to the best of our knowledge.

I agree to the above declaration, responsibilities and requirements as advised by Auzzie Families Homestay Care as set out on their website.

Please include an email address to send confirmation of this form submission*

QUICK LINKS

WHERE WE ARE

Address
PO Box 338 West Ryde NSW 1685 Australia
Phone
+61 2 8328 8499
Mobile
+61 419 125 822
Email
info@auzziefamilies.com

HOST APPLICATION – Auzzie Families Homestay Care