Guardianship Application form

Guardianship Application Form

Please complete the following form. A reply email will be sent to the School, Agent and Parent's email address to confirm that Homestay Australia PL is the Guardian (Carer) for the student listed.

Student's Information

First Name

Surname

Gender

School in Australia

Street Address

Suburb

State

Postal Code

School Contact Person

School Phone Number

School Fax Number

E-mail

Student's Date of Birth

Student's Current Address (if in Australia)

Address (cont.)

City

State/Postcode

Do you require Internet Access ?

Home Phone

Mobile Phone

Parent's Information

First Name

Last Name

Title

Organization

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Work Phone

Home Phone

FAX

E-mail

First Name
Surname
Gender
School in Australia
Street Address
Suburb
State
Postal Code
School Contact Person
School Phone Number
School Fax Number
E-mail
Student's Date of Birth

Student's Current Address (if in Australia)
Address (cont.)
City
State/Postcode
Do you require Internet Access ?
Home Phone
Mobile Phone

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
FAX
E-mail