Student Application

Student Application Form

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

Student’s Information

Family Name

First Name

Date of Birth

Nationality

Gender

Male
Female

Please upload your copy of passport

Click or drag a file to this area to upload.

Mobile

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Language you speak

Religion

Homestay start date(estimated)

Homestay end date(estimated)

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?

Self-introduction

Parent’s Information

Parents/Guardian 1 - Relation

Father
Mother
Guardian

Family Name

First Name

Nationality

Occupation

Mobile

Home Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Parents/Guardian 2

Father
Mother
Guardian

Family Name

First Name

Nationality

Occupation

Mobile

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

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Institution Information

Name of Institution Attending

Course Start Date

Course End Date

Contact Name:

Position Title

Phone

Please upload 'Letter of Offer' or 'eCoE'

Click or drag files to this area to upload. You can upload up to 4 files.

If you will attend more than one institution, please upload every institution's 'Letter of Offer' or 'eCoE'

Have you applied for a visa?

Education Agent Information

Name of Education Agency

Contact Name

Phone

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 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.
I agree to the Happy Homestay Adelaide Fees and Conditions.

Student Application

Student Application Form

Student’s Information

Parent’s Information

Emergency Contact

Institution Information

Education Agent Information

Additional Information

Declaration:

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Links

Contact