+61 7 5554 5656 or +61 423 374 908 info@esinternational.com.au

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Apply for
Home-Stay Placement

Fill out this form below and apply for home-stay placement today.

Please complete the form below to apply for home-stay placement

Step 1
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Your Details

Family Name

Given Names

Date of Birth

Gender

Male Female

Nationality

Religion

Address

Email Address

Telephone Number

Next of Kin Details

Contact Name

Relationship to You

Address

Email Address

Telephone

About You

Which languages do you speak?

Level of english

Fluent Coversation Minimal

Have you lived away from home before?

Yes No

Do you like children in the family?

Yes No

Do you like cats & dogs?

Yes No

Do you smoke?

Yes No

Do you have any allergies, medical conditions or special needs?

Yes No

Please give details

Do you take medication?

Yes No

Please give details

Are there any foods that you dislike?

Yes No

Please give details

What are your hobbies and interests?

Please tell us a little about yourself and the type of family that you would like to stay with?

Agent's Details

Company

Agent's Name

Telephone

Email Address

Place of Study

Are you studying in Brisbane or the Gold Coast?

Brisbane Goldcoast

Name of School

Course

Location

Start Date

Finish Date

Date of Arrival

Time of Arrival

Airline

Flight Number

Airport of Arrival

Homestay accommodation dates required

Arriaval Date

Depart Date

Package Inclusions

Accommodation placement fee

$240

Homestay Options Per Week

Full board including all meals no transport Single $370 Full board including all meals no transport Twin $680 Full board including all meals with transport Single $390 Full board including all meals with transport Twin $740 Under 18’s Full board including all meals no transport Single $360 Under 18’s Full board including all meals no transport Twin $680 Under 18’s Full board including all meals with transport Single $390 Under 18’s Full board including all meals with transport Twin $760 Board Only No Meals No Transport Single $290 Board Only No Meals No Transport Twin $540 Half board breakfast/Dinner weekdays all meals weekends no transport Single $330 Half board breakfast/Dinner weekdays all meals weekends with transport Single $350 Half board breakfast/Dinner weekdays all meals weekends no transport Twin $640 Half board breakfast/Dinner weekdays all meals weekends with transport Twin $670 Hight School student Gold Coast Full Board all meal with transport $380 Hight School student Brisbane Full Board all meal with transport $390 Hight School student Gold Coast Full Board all meal no transport $360 Hight School student Brisbane Full Board all meal with transport $370

Number of Weeks

Overseas TT or Credit Card Bank Fee

$40 ($40 bank charge or 3% for Credit Card payments over $1335.00)

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Please check the highlighted fields.

If you are unable to complete the form please fill out the attached form below

GOLD COAST – Student Homestay Application Form

BRISBANE – Student Homestay Application Form

Ready to get started?

Get in touch today

Get in touch

Call us:

Phone: +61 7 5554 5656

Mobile: +61 423 374 908

Email us:

info@esinternational.com.au

About ESI

ESI has new directors from early 2018 that are motivated and enthusiastic to serve both our families and our international guests.

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