Welcome - Study Tour Homestay Application Form

South Australian Government Schools - Study Tour 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

School Name *

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
*
2
3
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10

Add more people ..

2. Contact Details

Address line 1 *

Suburb *

Postcode *

Postal address
(if different from above)

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. About Your Family

What is your family cultural background? *

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? *

5. Other information

What kind of accommodation can you offer? *
(tick all that apply)

How will the student travel to and from school? *

6. Homestay Service Agreement and Declaration

  • a satisfactory Criminal History 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