SURNAME
HM PHONE
WORK PHONE
MOBILE PHONE
MS. FIRST NAME
DOB
OCCUPATION
MR. FIRST NAME
DOB
OCCUPATION
ADDRESS
SUBURB
EMAIL ADDRESS
CHILDREN AND OTHERS LIVING IN THE HOME
NAME
DOB
SEX
OCCUPATION
NAME
DOB
SEX
OCCUPATION
NAME
DOB
SEX
OCCUPATION
NAME
DOB
SEX
OCCUPATION
DO ANY FAMILY MEMBERS SMOKE ?
No
Yes
Would you accept a smoker?
No
Yes
PREFERRED
NATIONALITY
AGE
GENDER
DIET
DISTANCE TO NEAREST BUS STOP
ZONES TO THE CITY
ROOMS AVALIABLE FOR STUDENTS
AVAILABLE FROM
DO YOU HAVE ANY PETS
ETHNICITY OF HOUSEHOLD
HAVE YOU HAVE FORIEGN STUDENTS BEFORE
?
HOW LONG FOR ?
HOW MANY ?
LIST INTERESTS, SPORTS AND HOBBIES
WHY WOULD YOU AND YOUR FAMILY LIKE TO SHARE YOUR HOME WITH
A STUDENT
GENERAL COMMENTS ABOUT YOUR LIFESTYLE
BRIEF
DESCRIPTION OF YOUR HOME
DISLIKES
DO YOU HAVE INTERNET AVAILABLE
No
Yes
BROADBAND
No
Yes
DIAL-UP
No
Yes
ARE THE STUDENTS ABLE TO USE THE INTERNET
Yes
No
IS THERE A COST TO THE STUDENT?
Yes
No
