Formulaire de demande de famille d'accueil

Applicant Details

prénom*

Prénom Nom

Âge*

Nationalité*

Mother Tongue*

A photo of yourself

Adresse*

Adresse postale Adresse ligne 2 Town État / Province / Région Postal Code Pays

Téléphone fixe

Mobile*

Work Telephone

Email*

Details of Children / Other Family Members

Do you live with a partner?*

Oui
Nombre

Do any other family members live with you? Si c'est le cas, how many?*

Partners Details

prénom*

Prénom Nom

Âge*

Nationalité*

Mother Tongue*

Household Member 1

prénom*

Prénom Nom

Âge*

Le genre*

Living at home*

Household Member 2

prénom

Prénom Nom

Âge*

Le genre*

Living at home*

Household Member 3

prénom*

Prénom Nom

Âge*

Le genre*

Living at home*

Household Member 4

prénom*

Prénom Nom

Âge*

Le genre*

Living at home*

Autres détails

Please give details of any domestic pets including breed of cats and dogs

Does anybody at your home smoke?*

Are there any unusual family circumstances or medical problems?

Your home / House details

What type of house do you live in?*

Total number of bedrooms?*

Do you have a dining area?*

Oui
Nombre

Do you have a sitting room / lounge?*

Oui
Nombre

Total number of bathrooms?*

Number of toilets?*

Do you have central heating?*

Oui
Nombre

Photos of your house

Déposer les fichiers ici ou

Please try to include a picture of the front of your house if possible

Élèves

How many rooms do you have available to students?*

Room One*

Single
Twin Shared
Twin Alone
Double Alone
TV
En-suite bathroom

please select all that apply

Room Two*

Single
Twin Shared
Twin Alone
Double Alone
TV
En-suite bathroom

please select all that apply

Room Three*

Single
Twin Shared
Twin Alone
Double Alone
TV
En-suite bathroom

please select all that apply

A photo of the student/s bedroom

Déposer les fichiers ici ou

Facilities available to student(s)

Do students have exclusive use of any of the bathroom, shower and toilet facilities?*

Oui
Nombre

Place for private study, with chair?*

Oui
Nombre

Access at all times to the sitting room / lounge*

Oui
Nombre

Other facilities available to students?*

Any other facilities available for students?

Catering and Food Options

Please select all of the options below that you are happy to provide.

Food and catering options you are happy to provide?*

Maison de vacances (Room Only) - Set Times for Kitchen Use (Adult Students only)
Standard Package - (Lit - Déjeuner - Dinner and 2 Packed Lunch) - Any extras at additional cost
Special Diet Requirement - Halal Food
Special Diet Requirement - Vegetarian
Special Diet Requirement - Vegan
Special Diet Requirement - Gluten Free
Late check in and check out
Packed lunch - lundi à vendredi

Travel Information

Which bus routes can be used to travel to and from Canterbury City Centre?*

What is the approximate journey time to Canterbury City Centre?*

How far is your house from the nearest bus stop?*

Hosting Preferences

Number of Students you are willing to host?*

Sex*

Age Preference*

Moins de 18 ans
18 and Over

Do you drive and are you happy to collect and drop off under 18 students from their arrival and departure points.*

Oui
Nombre

Any restrictions?

Confirmation &; Consents

Consentement*

Please tick here to confirm it is acceptable to pass your details on to a third party when we are legally obliged to do so (for example a criminal record check or accreditation bodies)? Please note that this is very important for students’ welfare and it may affect our decision to lodge students with you.

Terms &; Conditions*

I agree to the Homestay Provider Terms & Conditions

Any other information?

CAPTCHA

Signed*

Name in CAPITALS*

Rendez-vous amoureux*

prénom

Ce champ n’est utilisé qu’à des fins de validation et devrait rester inchangé.

Formulaire de demande de famille d'accueil

Applicant Details

Details of Children / Other Family Members

Partners Details

Household Member 1

Household Member 2

Household Member 3

Household Member 4

Autres détails

Your home / House details

Élèves

Facilities available to student(s)

Catering and Food Options

Travel Information

Hosting Preferences

Confirmation &; Consents

Avez-vous des questions? Avez-vous besoin de plus d'informations?

How’;s Votre anglais?

Élèves

Agents

Chambres chez l'habitant

Terms &; politiques