Welcome - Nominated Homestay Application Form

South Australian Government Schools - Nominated Homestay Application Form

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1. Student Name

Family Name *

Given Name *

2. 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

Add more people ..

3. Contact Details

Address line 1 *

Suburb *

Postcode *

Postal address
(if different from above)

Home telephone

Mobile 1 *

Mobile 2

Email 1 *

Email 2

4. Emergency Contact Details

Name *

Relationship to Homestay Applicant *

Address *

Contact phone number/s *

Email *

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. 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.

    7. Homestay Service Agreement and Declaration

    • 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.