Homestay Accommodation UK - Student Application Form

Booking Form

...

If you prefer you can print out this form and then fax or post it to us.

If you are applying on-line, please ensure you are familiar with how to pay first.

Use the [Tab] key to move between entry fields.

...
...
Personal Details of person(s) requiring accommodation only
...
First Name :
Family Name :
...
Spouse :
1st Child :
2nd Child :
3rd Child :
...
Birthdate :	/ / dd mm yy
...
Sex :	Female Male
...
Home Address :






Country :
...
Nationality:
...
Telephone :
Fax :
E-Mail :
...
First language :
Religion :
...

What is your level of English?

Poor Fair Good

...
Have you travelled abroad before?	Yes No
Have you visited the UK before?	Yes No
Have you participated in a homestay visit before?	Yes No
Are you a smoker?	Yes No
...

What is your intended career? :
What are your hobbies or interests? :

...
Accommodation Required
...
Please indicate below the type of home that you would prefer :
...
Bed & Breakfast B&B + Evening Meal
...

Please tell us below if you have any special requirements,
such as food you cannot eat, allergies etc

Arrival Date :	/ / dd mm yy
Departure Date :	/ / dd mm yy
...
...
Details of study course in UK
This section is for students only
...
School or College:
...
Address :






...
Telephone :
Fax :
E-Mail :
...
Course :
Start Date :	/ / dd mm yy
Finish Date :	/ / dd mm yy
...

...
Payment Details
This section is only required if you require booking confirmation.
...
...
Payment Type :	Visa Mastercard American Express Sterling Bank Cheque Giro Money Order International Bank Transfer
...
Payment Amount :	(in � sterling)
...
Card Number :	/ / /
Expiry Date :	/
Cardholder Name :
...