Elementor #3292 - Happy Homestay Adelaide

Homestay Request - for Boarding Students Only

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Family Name

First Name

Date of Birth

Nationality

Gender

Mobile

Language you speak

Religion

Homestay Start Date

Homestay end date

Do you smoke?

Do you have any medical condition/s?

Do you have any allergy?

Do you have any special dietary requirements?

Are you comfortable with pets?

Any other information?

Name of Institution Attending

Contact Person(Institution)

Contact Person Email(Institution)

Contact Number(Institution)

Declaration of Happy Homestay Adelaide

I confirm that the information given in this form is true, complete, and accurate.

Declaration of Happy Homestay Adelaide Information and data policy

I hereby give Happy Homestay Adelaide permission to collect, use and disclose relevant information about the student for the purpose of the student’s homestay arrangement.

Declaration of Happy Homestay Adelaide Student Code of Conduct

I have read and understood the HHA Student Code of Conduct.(Submission required)