HOMESTAY contact homestay consultancy

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About You      

First Name


Family Name:

Home address Date of birth: (dd/mm/yyyy)  
Gender: Male Female  
Home Phone: Nationality:
Mobile Phone: Home Language:  
Email address Other Languages  
Please provide details of at least one emergency contact  

Contact Address/Telephone Number

Relationship to you

Please give details of any medical conditions that Homestay Consultancy should be aware of (if you wish to discuss this in more detail, please advise):  
   Accommodation  (please indicate your requirements)
Bed & Breakfast




Self Catering


  Are you happy to stay with a family who have pets? Yes   No
  Are you happy to stay with a family who smoke? Yes   No
  Arrival date:
  Departure date:
School  (only applicable if booking a course with Homestay Consultancy)
  Number of hours you wish to study with the school per week:
30 hours 22.5 hours    
15 hours (am) 15 hours (pm) None
  Please indicate the number of weeks of the course:  
Please provide the start date of your course:
  Other Information    
  Do you require a transfer from the Airport? Yes   No  
  Details of Airport Transport required (Taxi?)  
  Please give details of any personal requirements, which have not already been stated.  We will do our best to accommodate any request:  
  By completing this form and returning it to Homestay Consultancy I agree to the Terms and Conditions and those found on the Homestay Consultancy website.  I hereby declare that the information I have provided is true and correct, and that I am  over the age of 18*.  (*If not please ask a parent or guardian to complete on your behalf).

Please tick this box to confirm you have read and agree to our terms and conditions


Host Families Cambridge


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