澳大利亚寄宿家庭申请表

Accommodation Placement Form

All applications must be received by Study Vision at least 10 days (minimum) prior to arrival

A- Student Details

Family Name: ___________________ Given Names: _________________________

Date of Birth: ____ / ____ / ____ Sex: _ Male _ Female

Nationality: _________________________ Passport No. (if available):_______________

Current Address in Australia (if applicable): ___________________________________________________

Telephone: _______________ Mobile:___________________ Email: ____________________________

Parents’ Address (overseas): ________________________________________________________________

Telephone: _______________ Mobile:___________________ Email: ____________________________

Name of Education Provider in Australia: _____________________________________________________

Campus Address: _____________________________________ Telephone: _______________________

Course of Study: ________________________________________________________________________

Date of Arrival to Australia: ____ / ____ / ____ Flight No.: _____ Estimated Arrival Time: ______

B - Accommodation Requirements

Preferred Accommodation: _ Homestay (with Australian Family) _ Shared Unit/House (with other students)

Room Sharing Preference: _ Single _ Shared _ Single or Shared

Required Accommodation Start Date: ____ / ____ / ____ Length of Stay:______________ weeks (min. 4 weeks)

Do you Smoke? _ Yes _ No Do you mind pets (such as cats/dogs) at home? _ Yes _ No

State any other special requirements: ______________________________________________            ________________  

__________________________________________________________________________________________                                                       _____

C-Fees & Conditions

Please refer to our current price list (available upon request). All fees must be paid before services will be rendered.

Please note that no refunds are made once fees are paid.

E- Student/Parent Declaration

I, __________________________________ (Student / Parent : circle one only) hereby make application for Accommodation

Placement to Study Vision. I hereby declare that all information provided in this application is true and accurate. I agree to pay

rent on time and obey all house rules.

Student’s Signature: ____________________________ Date: ___ / ___ / ____

Parent’s Signature: ____________________________ Date: ___ / ___ / ____

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