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HOST APPLICATION
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
*
Select....
Adelaide
Brisbane
Melbourne
Sydney
Accommodation type
*
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Homestay
Self Catering
Granny flat
Home Nomination
Personal Details - Main Host
Title
*
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Mrs.
Mr.
Ms.
Dr.
First Name
*
Surname
*
Preferred Name
*
Date of Birth
*
Must be dd/mm/yyyy
Occupation
*
Home Phone
Mobile Phone
*
E-mail Address
*
Other Languages Spoken
*
Religion
*
Smoker
*
Select....
Yes
No
WWCC/BC Number (If known)
WWCC / BC If you have a WWCC / BC please enter the details below
Issue Date
Expiry Date
Address
Street Address
*
Suburb
*
State
*
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New South Wales
Queensland
South Australia
Tasmania
Victoria
Western Australia
Northern Terriroty
Australian Capital Territory
Post Code
*
Current Household Members
Do you have a partner, children, or any other people who live with you? If yes, please add their details below:
Click the box to add child / other resident
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List
Name
DOB
Gender
Relationship
Occupation
Female
Male
Spouse/Partner
Child
Grandparent
Other Relative
Friend
Boarder
Other
Do you have any pets? If yes, click here to add pets
enable
List
Type of pet
Name
Breed
Hosting Information
Gender preference
*
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Female
Male
Either
Do you need the student to do their laundry?
*
Select....
Yes
No
Do you need the student to do household chores?
*
Select....
Yes
No
Do you have previous hosting experience?
*
Select....
Yes
No
Type of food cooked in home
*
Asian
Kosher
Vegetarian
Gluten Free
Modern Western
Vegan
Halal
Hobbies / Interests
*
Sport - Playing
Computer Game
Reading
Outdoors - Beach, walking
Dancing
Watching TV / Netflix
Play Musical Instrument
Movies
Time with Friends
Shopping
Gym
Home Details
Home type
*
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Freestanding House
House with Granny Flat
Terrace / Townhouse
Unit / Apartment
Home condition is
*
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New
Renovated
Older Style
Home is
*
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Owned
Leased with current contract
Leased without current contract
Leased privately
Total No. of bedrooms in home
*
1
2
3
4
5
6
7
8
No. of bedrooms available for students
*
1
2
3
4
Total No. of bathrooms in home
*
1
2
3
4
5
6
No. of bathrooms for student use
*
1
2
3
4
Click the box to add student bedroom details
enable
List
Room no:
Size
Bed size
Bathroom
Occupied
Available date
Room facilities
1
2
3
4
Single
Double
Twin
Single
King single
Double
Queen
Twin
Bunk
Shared with family
Shared with the students
Ensuite
Yes
No
Other facilities available
Please describe your home
*
Please describe the main public transport available from your home
*
Payment Details
Homestay Fees are paid directly into your bank account. Please provide details:
Hidden
Bank
Hidden
Branch
Hidden
Account Name
Hidden
BSB Number
Hidden
Account Number
Public Liability & Home Content Insurance
Do you have public liability Insurance?
*
Select....
Yes
No
Name of the Insurer
Policy number
Covered amount
Do you have home contents insurance?
*
Select....
Yes
No
Name of the insurer
Policy number
Covered amount
Does your policy cover the boarder(s)?
Note: Families taking overseas students must have compulsory public liability insurance.
Declaration
I/We understand the responsibilities and requirements of hosting an international student.
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.
I/we approve Auzze Families Homestay Care to collect, hold & work with my personal records solely for the purpose of conducting homestay agency duites.
By providing Auzzie Families Homestay Care with your personal information you consent to us collecting,disclosing,storing & using it in accorance with our Privacy Policy
You have obtained prior consent to supply personal information of any other household members.
We certify the answers given are true and correct to the best of our knowledge.
Please include an email address to send confirmation of this form submission
*
By submitting the form, I agree to the above declaration, responsibilities and requirements as advised by Auzzie Families Homestay Care as set out on their website.
Comments
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