Host Family Application | Eastern shores international homestay

ESI Host Family Application

Please complete the form below to apply to be a host family

Step 1
Step 2
Step 3
Step 4
Step 5

Your Information

Your First Name

Family Name

Date of Birth

Country of Brith

Occupation

Address

Post Code

Suburb

Email Address

Mobile

Home Phone

Work Phone

Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Brith

Occupation

#2 Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Birth

Occupation

#3 Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Birth

Occupation

#4 Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Birth

Occupation

Blue Cards Details

Do you and all members of your family aged 18 and over that live with you have a Blue Card?

Yes No

Full Name

Blue Card Number

Blue Card Expiry Date

Full Name

Blue Card Number

Blue Card Expiry Date

Your application

How did you hear about us?

Referee details

Referee Name

Referee Phone Number

Final Notes

Is there anything else that you can tell us that would be helpful for processing your application?

Acknowledgement

I / we acknowledge that Eastern Shores International accepts no responsibility in relation to homestay placements and I / we agree to release and discharge Eastern Shores International their servants and agents from any action, proceeding, claim, demand, costs, losses, damages and expenses arising out of this agreement. I / we understand that two week's notice must be given to Eastern Shores International if I / we want to terminate the Homestay Student arrangement.

If you are unable to complete the form please fill out the attached form below

Host Family Application Form

Become a Host Family

ESI Host Family Application

Your Information

Your First Name

Family Name

Date of Birth

Country of Brith

Occupation

Address

Post Code

Suburb

Email Address

Mobile

Home Phone

Work Phone

Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Brith

Occupation

#2 Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Birth

Occupation

#3 Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Birth

Occupation

#4 Family and Guests Details

Full Name

Relationship

Date of Birth

Country of Birth

Occupation

Family Information

Name of School your child/ren attend:

Family Interests

Does anyone in your household smoke?

Will you allow a student to smoke?

Are there any dietary restrictions in your home?

Pets

Pet type

If other, please specify

Indoor / Outdoor

Further Home Details

How many spare bedrooms do you have for students?

Do you have a preference for the gender of students that you host?

Are you prepared to drop the student off and pick them up from school?

How close to your home is the nearest bus stop? (estimate in meters)

Which buses stop there?

Write a brief description of your home including facilities

Will a student will have a room of his/her own, internet access, a desk, lamp and a chair in a quiet place?

Tell us what you think makes a good host family for overseas students

Blue Cards Details

Do you and all members of your family aged 18 and over that live with you have a Blue Card?

Full Name

Blue Card Number

Blue Card Expiry Date

Full Name

Blue Card Number

Blue Card Expiry Date

Your application

How did you hear about us?

Referee details

Referee Name

Referee Phone Number

Final Notes

Is there anything else that you can tell us that would be helpful for processing your application?

Acknowledgement

Ready to get started?