Friday, May 18, 2012
Students Homestay Application
Standard Homestay Application Form 2012-2013

Homestay Application Form
The information you provide in this Application will assist us to place you with a suitable host family. Our goal is to ensure that your stay in Australia is as memorable an experience as possible for you, an experience you can remember and cherish your entire life.

Fileds marked with (*) are required.

About you ...
Family Name   (*)
Please enter your family name		 Given Names (*)
Please enter your given name(s)
Gender
Please select either Male or Female for your gender		 Date of Birth
 Enter your date of birth as dd.mm.yyyy.
You need to enter your birthdate in the form dd.mm.yyyy for 22 March 1996 enter 22.03.1996 or use the pop-up calendar
Address
Please enter your street address
Invalid Input
City/Suburb
Please enter your City/Suburb or town/village		 Province/State
Please enter your Province or State
Postal Code
Country
Invalid Input
Please Note: Include your country and area codes eg. +65 99999 9999
Home phone
Invalid Input		 Fax number
Invalid Input
eMail (*)
Please enter a valid email address		 Confirm eMail (*)
Please enter a valid email address
Religion (*)
Please enter your religion as this often helps with placing with your host family, if you do wish to advise your religion, please enter N/A.

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