Oz Homestay

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Personal Details - Host
First Name Occupation
Last Name
Part or Full Time Telephone (business)
Fax Mobile
Email DOB (dd/mm/yyyy) Calendar
Smoke    
Personal Details - Spouse (leave blank if N/A)
Enter Spouse Details?
Name of Spouse / Partner Occupation
Part or Full Time Telephone (business)
Fax Mobile
Email DOB (dd/mm/yyyy) Calendar
Smoke    
Address & Home Number
Home Address
Suburb
Post Code Home Telephone
Children
Do you have children?
Number of Children? (form will expand - ignore if no children)
Child 1 Name Son or Daughter
Child 1 DOB (dd/mm/yyyy) Calendar    
Child 2 Name Son or Daughter
Child 2 DOB (dd/mm/yyyy) Calendar    
Child 3 Name Son or Daughter
Child 3 DOB (dd/mm/yyyy) Calendar    
Child 4 Name Son or Daughter
Child 4 DOB (dd/mm/yyyy) Calendar    
Travel Distance
Please select from the following regions those that are closest to your home -we guarantee students 40 minutes travel time, door to door by public transport from their homestay to institution of study, preferably by one form of transportation.
  • City CBD
  • Inner West
  • Northern Beaches
  • Liverpool
  • Campbelltown
  • Parramatta- Penrith
  • The Hills Districts
  • St George region
  • UNSW
  • Bondi
  • Canterbury-Bankstown
  • Macquarie University
  • Lower North Shore
  • Upper North Shore
  • Sutherland Shire
Public Transport
Public Transport
House Details
Do you have any pets (please describe)
Interests / Hobbies
Other languages spoken in house
Type of food cooked in home Asian
Vegetarian
Australian
Halal
 Do you want students to do their own laundry?
Internet available at home? (if yes please indicate)
ADSL
Cable
dialup
wireless
unwired 		Other Facilities Available? (Pool, Instruments, computers etc)
Special Requests
Prefer Male / Female? Smoker?
Nationality Preference? Age Preference? No Preference
< 15
15 - 18
18 - 21
21 - 25
25+
Guardianship
Are you prepared to act as a guardian for your student if necessary?
Payment Details
Would you like Oz Homestay to pay for homestay fee directly into your bank account? Bank
Branch BSB Number
Account Number Name on Account
Public Liability Insurance
Do you have public liability insurance? Insurer
Cover Number Cover $ (million)
Home Contents Insurance
Do you have home contents insurance?
Insurer Cover Number
Note: Families taking students from Pittwater House Schools must have compulsory public liability insurance and home contents insurance. For specific homestay insurance please contact RSM group TEL: 1300 654 494
Bedrooms
How many bedrooms do you have available for students? (form will expand)
Bedroom 1 Features
Bed
Ensuite
TV
Desk
Lamp
Bedroom 2 Features
Bed
Ensuite
TV
Desk
Lamp
Bedroom 3 Features
Bed
Ensuite
TV
Desk
Lamp
Number of bathrooms available
Referees (2 required)
Referee Name Referee Telephone Number
Referee Name Referee Telephone Number
Description & Comments
Please describe your home
Additional Comments
Terms and Conditions

 

Declaration

I/We understand the conditions* in hosting an international student. We also understand that Oz Homestay is not responsible for any accidents, damages or loss incurred by us as a result of negligence of the student and we will negotiate this with the student directly. We certify the answers are true and accurate to the best of our knowledge.

I agree to the above declaration, terms and conditions

 

 

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Last modified: 21-06-08