Online Homestay Application Form

Student Information

Full Name of Student (required)
Student's Date of Birth (required)
Nationality (required)
First Language (required)

Gender (required) MaleFemale

Your Contact Email (required)
Your Contact Home Phone (required)

Home Address (required)

Are you in New Zealand now? YesNo
If so, what is your date of arrival

 

Emergency/Alternative Contact Person Information

Emergency contact name (required)
Relation to you (required)
Your Contact Email (required)
Emergency contact phone number (required)

 

Please answer the following questions if you are under 18

Name of your school
Year of Study (if applicable)
Guardian name
Guardian contact phone number
Guardian contact email address
Note: NZESTAR offers the guardianship service to students under 18. For more information, please refer to the guardianship page on this website, or email us for more info.

 

Student Personal Information

What is your English speaking level?
Have you ever studied in another country?
Do you smoke?
Note: Students are NOT permitted to smoke inside the homestay homes. Some homestay families allow students to smoke outside of their home.
Are you allergic to any animals?
If so, please specify
Do you have any medical conditions that the homestay families need to know?
If so, please specify

Special dietary requirement, meat requirement? vegetarian? please supply as much info as possible

Religious belief

Hobbies

Will you have your own car at your homestay?
If yes, what's your driver's license number?

 

Terms and Conditions

By submitting this application, you certify that you understand and agree to the following terms and conditions:

  • The prices listed above are valid in 2016. Prices are subject to change at any time without notice.
  • A non-refundable homestay placement fee is required when the students submit a homestay application form.
  • Student who request to transfer from one homestay to another will be charged a transfer fee of $100.
  • The homestay application must be submitted to the homestay team no later than 2 weeks before arrival. Students who submit a late application will be charged a NZD$100 emergency homestay placement fee.

Signing Off

Signed by full Name of Applicant (required)
Signed-Date

Check to sign this form: I agree