HOMESTAY APPLICATION

HOMESTAY APPLICATION FORM

Complete and send the form below. Be sure to attach a photo.
Alternatively download a copy of the form Homestay Accommodation Form >>

* Indicates required field

Name of Student *

First

Last

Upload photo *

Max file size: 20MB

Male/Female *

Religion *

Address *

Telephone *

Fax *

Email *

Date of birth *

Do you smoke? *

Do you have any allergies or health problems? *

Hobbies/Sports/Interests *

Food likes *

Food dislikes *

Do you have any special dietary requirements? *

Do you like animals? *

Do you come from an active family life or a quiet family life? *

Do you do household chores at home? *

Have you travelled outside of your country before? *

What are your goals in coming to our school? *

What is your English language level? *

Low Intermediate Advanced

Who lives with you?

Father's name *

Occupation *

Mother's name *

Occupation *

Brothers, sisters and other family members

Name *

Age *

Occupation *

Relationship *

Name *

Age *

Occupation *

Relationship *

Name *

Age *

Occupation *

Relationship *

Tell us about yourself - the subjects you are studying a school, music or sports that interest you, what you hope to see or do in New Zealand, your family life in your home country. *

Please give arrival details if you have them (date, time, airline, etc) *

If you want to write a separate letter to your host family please attached here *

Max file size: 20MB

Thank you for telling us a little about yourself. We look forward to meeting you.

SEND

Note: If you wish to move homestay, two week’s notice must be given in writing to the host family. The funds payable for the notice are paid to the host family regardless of the day you move within that two week period. The host family may also give two week’s notice in writing to the student. Birkenhead College reserves the right to move a student without notice at its own discretion if the student is deemed to be in an unsafe environment.