Formularz wniosku o rodzinę goszczącą

Applicant Details

Nazwa*

Pierwszy Ostatni, ubiegły, zeszły

Wiek*

Narodowość*

Mother Tongue*

A photo of yourself

Adres*

Adres ulicy Address Line 2 Town stan / prowincja / region Postal Code Kraj

Home Phone

mobilny*

Work Telephone

E-mail*

Details of Children / Other Family Members

Do you live with a partner?*

tak
Nie

Do any other family members live with you? W takim razie, how many?*

Partners Details

Nazwa*

Pierwszy Ostatni, ubiegły, zeszły

Wiek*

Narodowość*

Mother Tongue*

Household Member 1

Nazwa*

Pierwszy Ostatni, ubiegły, zeszły

Wiek*

Płeć*

Living at home*

Household Member 2

Nazwa

Pierwszy Ostatni, ubiegły, zeszły

Wiek*

Płeć*

Living at home*

Household Member 3

Nazwa*

Pierwszy Ostatni, ubiegły, zeszły

Wiek*

Płeć*

Living at home*

Household Member 4

Nazwa*

Pierwszy Ostatni, ubiegły, zeszły

Wiek*

Płeć*

Living at home*

Inne szczegóły

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?*

tak
Nie

Do you have a sitting room / lounge?*

tak
Nie

Total number of bathrooms?*

Number of toilets?*

Do you have central heating?*

tak
Nie

Photos of your house

Drop files here or

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

studenci

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

Drop files here or

Facilities available to student(s)

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

tak
Nie

Place for private study, with chair?*

tak
Nie

Access at all times to the sitting room / lounge*

tak
Nie

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?*

Self Catering (Room Only) - Set Times for Kitchen Use (Adult Students only)
Standard Package - (Łóżko - Śniadanie - 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 - od poniedziałku do piątku

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*

Under 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.*

tak
Nie

Any restrictions?

Confirmation &; Consents

Zgoda*

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 &; Warunki*

I agree to the Homestay Provider Terms & Conditions

Any other information?

CAPTCHA

Podpisano*

Nazwisko DRUKOWANYMI LITERAMI*

Data*

Komentarze

To pole jest dla celów walidacji i powinna być pozostawiona bez zmian.

Formularz wniosku o rodzinę goszczącą

Applicant Details

Details of Children / Other Family Members

Partners Details

Household Member 1

Household Member 2

Household Member 3

Household Member 4

Inne szczegóły

Your home / House details

studenci

Facilities available to student(s)

Catering and Food Options

Travel Information

Hosting Preferences

Confirmation &; Consents

Czy masz pytania? Potrzebujesz więcej informacji?

How’;twoja angielsku?

studenci

Agencje

Gospodarze Homestay

Terms &; polityka