Skip to content

Home
About
- HHA
- Adelaide
Students
Hosts
Schools
Educational Tours
Contact

Student Application

Student Application Form

How did you hear about the Happy Homestay Adelaide Homestay Program?

Internet
Friend/Relative
Advertisement
Local School
Current HHA homestay student referral (if yes, specify name below)

Current HHA homestay name:

Student’s Information

Salutation *

Dr
Mr
Mrs
Miss
Ms

Family Name *

First Name *

Date of Birth *

Nationality *

Mobile *

Email *

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Language you speak *

Religion *

Length of Homestay required *

From

Length of Homestay required *

To

Do you smoke? *

Yes
No

Do you suffer from any medical condition/s? *

If yes, please specify: *

Do you suffer from any allergy? *

If yes, please specify: *

Do you have any special dietary requirements? *

If yes, please specify: *

Are you comfortable with pets? *

If only some, please state (e.g: Cat): *

What are your hobbies/interests? *

Parent’s Information

Parents/Guardian 1 *

Dr
Mr
Mrs
Miss
Ms

Family Name *

First Name *

Nationality *

Occupation *

Mobile *

Email *

Home Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Parents/Guardian 2

Dr
Mr
Mrs
Miss
Ms

Family Name

First Name

Nationality

Occupation

Mobile

Email

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Emergency Contact

Relationship to student: *

Family Name *

First Name *

Nationality *

Occupation *

Mobile *

Email *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

School Information

Name of School Attending *

School Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Start Date *

Duration *

Contact Name: *

Position Title *

Phone *

Email *

Education Agent Information

Name of Education Agency

Contact Name

Phone

Email

Additional Information

Additional Information

Declaration:

Declaration of Happy Homestay Adelaide Fees and Conditions: *

I confirm that the information given in this form is true, complete, and accurate.
I agree to the Happy Homestay Adelaide Fees and Conditions.

South Australia’s very own Homestay experts professionally matching the needs of international students with Adelaide families since 2003

Gallery

Footer P1

Footer P2

Footer P4

Footer P5

Links

Educational Tours

Contact

We’d love to hear from you

hha@happyhomestay.com.au

hha@happyhomestay
.com.au

+61 8 8276 4476

Po BOX 495, Park Holme,
South Australia 5043

Copyright © 2022 Happy Homestay Adelaide
Privacy Policy | Terms of Use