Modulo di domanda per la famiglia ospitante

Applicant Details

Nome*

Nome Cognome

Età*

Nazionalità*

Mother Tongue*

A photo of yourself

Indirizzo*

Via/Piazza/Corso e numero civico seconda riga per indirizzo Town Stato / Provincia / Regione Postal Code Nazione

Telefono di casa

Mobile*

Work Telephone

E-mail*

Details of Children / Other Family Members

Do you live with a partner?*

sì
No

Do any other family members live with you? Se è così, how many?*

Partners Details

Nome*

Nome Cognome

Età*

Nazionalità*

Mother Tongue*

Household Member 1

Nome*

Nome Cognome

Età*

Genere*

Living at home*

Household Member 2

Nome

Nome Cognome

Età*

Genere*

Living at home*

Household Member 3

Nome*

Nome Cognome

Età*

Genere*

Living at home*

Household Member 4

Nome*

Nome Cognome

Età*

Genere*

Living at home*

Altri dettagli

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?*

sì
No

Do you have a sitting room / lounge?*

sì
No

Total number of bathrooms?*

Number of toilets?*

Do you have central heating?*

sì
No

Photos of your house

Trascina i file qui oppure

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

Studenti

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

Trascina i file qui oppure

Facilities available to student(S)

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

sì
No

Place for private study, with chair?*

sì
No

Access at all times to the sitting room / lounge*

sì
No

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?*

Vitto escluso (Room Only) - Set Times for Kitchen Use (Adult Students only)
Standard Package - (Letto - Colazione - 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 - lunedi al venerdì

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*

Sotto i 18
18 and Over

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

sì
No

Any restrictions?

Confirmation &; Consents

Consenso*

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 &; condizioni*

I agree to the Homestay Provider Terms & Conditions

Any other information?

CAPTCHA

Signed*

Name in CAPITALS*

Date*

Commenti

Questo campo serve per la convalida e dovrebbe essere lasciato inalterato.

Modulo di domanda per la famiglia ospitante

Applicant Details

Details of Children / Other Family Members

Partners Details

Household Member 1

Household Member 2

Household Member 3

Household Member 4

Altri dettagli

Your home / House details

Studenti

Facilities available to student(S)

Catering and Food Options

Travel Information

Hosting Preferences

Confirmation &; Consents

Avete domande? Avete bisogno di ulteriori informazioni?

How’;s Your English?

Studenti

Agents

famiglie ospitanti

Terms &; Politiche