2024 HOMESTAY FORM FOR ABHS FAMILIES

Please list your children's names currently attending ABHS *

Family Details:

Street number and street name *

Suburb *

Postcode *

Home telephone number

Mobile number *

Email address *

Parent/Guardian (P/G) 1 Details:

P/G1 First name: *

P/G1 Surname *

P/G1 Date of birth: *

P/G1 Age *

P/G1 Gender: *

MaleFemaleOther

P/G1 Occupation

Parent/Guardian (P/G) 2 Details:

P/G2 First name

P/G2 Surname

P/G2 Date of birth:

P/G2 Age

P/G2 Gender

MaleFemaleOther

P/G2 Occupation

Other Information:

Main language spoken at home: *

English Other

If other, which languages are spoken? *

Do you have any pets? *

YesNo

Please list the type of animals and whether they are indoor or outdoor pets: *

Does anyone in the house smoke? *

YesNo

If yes, do you smoke inside or outside? *

Are you willing to have a Working with Children Check conducted for every member of the household older than 18 years? *

YesNo

Does anyone in the home have any psychological or medical conditions that might affect your ability to host an exchange student? *

YesNo

If Yes, please provide details and discuss with your ABHS contact person *

Has your family previously hosted an overseas student? *

YesNo

Will the visiting student share a room? If yes, please provide further details. *

How will the student travel to and from school? *

Give a brief description of your home (i.e. number of rooms, bedrooms, bathrooms, garden etc) *

Names of Other People Living at the Property:

Child #1 Full Name (under 18 yrs)

Child #1 Gender

Child #1 Age

Child #2 Full Name (under 18yrs)

Child #2 Gender

Child #2 Age

Child #3 Full Name (under 18yrs)

Child #3 Gender

Child #3 Age

Child #4 Full Name (under 18yrs)

Child #4 Gender

Child #4 Age

Family Member #1 Full Name (over 18 yrs)

Adult Family Member #1 Gender

Adult family member #1 Age

Family Member #2 Full Name (over 18yrs)

Adult Family Member #2 Gender

Adult family member #2 Age

Family Member #3 Full Name (over 18 yrs)

Adult Family Member #3 Gender

Adult family member #3 Age

Family Member #4 Full Name (over 18 yrs)

Adult Family Member #4 Gender

Adult family member #4 Age

Please List your Families Interests & Hobbies:

Tell us about yourself - List a few things that you can contribute to your role as a host family *

Your signature *

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