Brisbane College of Australia

Accommodation » Homestay Request Form

Personal Details

Preferences

Would you prefer a shared room or single room?

Shared

Single

Do you want to be placed in a smoking or non-smoking family?

Non-Smoking

Smoking

Don't Mind

Medical Information

Do you have any illnesses, allergies or conditions which your Homestay family will need to be made aware of ?

Yes No

If yes, please give details:

Are you allergic to:

1. Any medication? Yes No

If yes, please give details:

2. Any food? Yes No

If yes, please give details:

3. Any Pets? Yes No

If yes, please give details:

English Level

Likes & Dislikes

Do you have any hobbies? Yes No

If yes, what are they?

I would prefer a home/house: (you make choose more than one)
With other students my age
With other students of a different age
I don't mind
With pets
Without pets
With no other students from my country
With students from my country