Online Accommodation Application

Personal Details
First Name
Family Name
Gender	Male Female
Date of Birth
Nationality
Religion
Language Spoken
Email Address
Course enrolment
Course commencement
Preferences
What accommodation would you prefer	Homestay (excellent condition) Homestay (ordinary condition) Shared Accommodation House Apartment
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 aware of?	No Yes - Please specify
Are you allergic to:
Medication	No Yes - Please specify
Food	No Yes - Please specify
Pets	No Yes - Please specify
English Level
Current level of English
Preferences
Personality Type
What foods do you like and dislike?	Like: Dislike:
What are your hobbies?
I would prefer a home/house (you may choose more than one)	With other students my age With students from my country With other students of a different age I don't mind With pets Without pets With no other students from my country
Accommodation Duration
Accommodation Start Date	dd/mm/yyyy
Duration	weeks
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