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.

 

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