Section 1: Student details and contact information
Agent Contact Details
Emergency Contact Details
Section 2: Course Information
Name of course 1
Name of course 2
Start date (DD/MM/YYYY)
Duration
Campus
Section 3: Airport Reception
Do you require airport pick up? Yes No
Melbourne Arrival Date (DD/MM/YYYY)
Melbourne Arrival Time (AM/PM)
Airline Flight Number
Are you arriving with a relative or friend who is not a Swinburne student? Yes No Note - Non Swinburne students must pay directly to the driver for their airport pick-up. You will be advised of the cost of the pick-up when you receive your confirmation.
Section 4: Pre- Allocated Homestay
How long do you plan to stay in homestay for? weeks
We need some personal information about you in order to find a suitable homestay.
Age
Level of English Beginner Acceptable Good
Smoker? Yes No
Hobbies and Interests
Religion
Languages Spoken
Have you travelled overseas before?
Yes - Where?
No
Do you have any medical condition (eg asthma, allergies) or disability?
Yes - What?
Is there any food you do not eat?
No children Children under 12 years Children over 12 years No pets
No dogs No cats Single room Twin share room (single sex only)
Any other information?
Section 5: Declaration
By clicking the "Submit" button, I confirm that I am applying for a pre-allocated homestay and I declare that I have read, understood and accept the Homestay Conditions provided to me by Swinburne University of Technology. I agree to abide by these conditions. I release Swinburne University of Technology from any liabilities arising from my placement in homestay accommodation. I understand that I must undertake to establish a written agreement with my homestay provider that we both agree to and sign.
