Welcome - Homestay Application Form

South Australian Government Schools - Homestay Application Form

We recommend that you use Mozilla Firefox or Google Chrome web browsers to complete this form. Please note: Fields indicated with an * is a required field.

AUTOFILL FORM TEXT INPUTS

1. People Living in your Home

Please list all persons residing in your home including family members, other international students and those who stay overnight on a temporary basis.

Resident Relationship to Homestay Applicant Family Name Given Name Gender Date of Birth Occupation and working hours or school attending Current Child Related Employment Screening clearance
1 *
2
3
4
5
6
7
8
9
10

Add more people ..

2. Contact Details

Address line 1 *

Suburb *

Postcode *

Postal address

Home telephone

Mobile 1 *

Mobile 2

Email 1 *

Email 2

3. Emergency Contact Details

Name *

Relationship to Homestay Applicant *

Address *

Contact phone number/s *

Email *

4. Your Student Preference

Gender *

Duration *
(tick all that apply)

Nationality *

Age Group *

How many students do you wish to accommodate? *

What kind of accommodation can you offer? *

Would you accept a student with a special dietary restriction? *

5. About Your Family

What is your family cultural background? *

Does your family have religious affiliations? *

What is the main language spoken at home? *

What other languages are spoken at home?

What activities do you regularly enjoy as a family?

Does your family have special dietary preferences? *

Does your family have pets? *

Does anyone in the home smoke? *

6. Prior Homestay Experience

Are you currently listed to host international students with any other organisation/s? *

Have you hosted international students in the last 2 years? *

7. Homestay who referred you to the Homestay program (if applicable)

Family name

Given name

Why did this Homestay recommend the Homestay program to you?

8. How did you hear about the South Australian Government Schools Homestay program? *

9. Why are you interested in becoming a Homestay? *

Choose more than one option if applicable

10. Photo Upload

Please submit recent colour photos of your family, pets and home including the front of your house, backyard, student bedroom, bathroom and living rooms.

Uploaded photos

Please allow time for your photos to upload. If your photos do not upload, please email them to education.homestay@sa.gov.au

    Total: 0 photos uploaded.

    11. Homestay Service Agreement and Declaration

    • a satisfactory Child Related Employment Screening is required for all persons over the age of 18 residing in the home
    • a suitable student match is available and accepted by the education agent and/or overseas family.

    • provided to the South Australian government school where the student will be attending
    • provided to the Department of Home Affairs (DHA) if the student is on a student visa.