Homestay Host Application

Please complete the form below and a Talkabout Tours representative will contact you regarding your registration.

Please note that fields marked with a '*' are required.

First Name *

Last Name *

Home Phone *

Mobile Phone

Fax

Address

Suburb

Postal Code

Nationality

E-mail *

Preferred Correspondence Method

Email Letter Fax

Type of Dwelling

Ownership

Brief description of Dwelling

No. of Bedrooms

No. of Bathrooms

Amenities Swimming Pool Games Room

Other relevant information (eg. nearby facilities)

Does student have access to Computer T.V. Laundry

How much?

Do you have house and contents insurance?

Yes No

Do you have public Liability Insurance?

Yes No

No. of available Bedrooms

Access to public transportation: Bus Train

Proximity to Bus/Train km

How long does it take to get to UWA by bus or train? hours

How long does it take to get to Perth by bus or train? hours

Occupants [Adults]

	Adult's Name	Adult's Occupation
1.
2.
3.
4.

Occupants [Children]

	Child's Name	Child's Age
1.
2.
3.
4.

Does anyone in the house smoke?

Yes No

Can the students smoke?

Yes No

Can the students smoke [inside]?

Yes No

Can the students smoke [outside]?

Yes No

Could you cope with special dietary considerations?

Yes No | Considerations

Pets

Police Clearance

Yes No

Do you have a Working with Children Clearance (Blue card)? (Mandatory for hosting under 18 year olds)

Yes No Will get one

Lifestyle

Quiet Active In Between

Special interests/hobbies/sports

Have you had some homestays before?

Yes No

If yes, through which organization?
If yes, what nationality?

When is/are your room available? (DAY / MONTH / YEAR)

Have you any reservations with regard to race, nationality, religion, gender or age?

Yes No

If yes, please elaborate

Comments and/or Additional Information

Please Click Here To Review our Terms and Conditions...
Yes, I Have Read and Accept Your terms and Conditions.*

Fax Request

If you would prefer to fax us your registration then please download the application form below and fax it to us on (61) 08 9319 9327.

Host Application Form (PDF)

We look forward to hearing from you...