Homestay application form for
If you require the NT Government to arrange accommodation for you, then you will need to complete this form.
Please complete all sections of this form and return it with your application form.The Department’s Homestay Accommodation fee is AU$270.00 per week which includes two meals per day and your own bedroom (three meals during weekends and Public Holidays). Payments for Homestay Accommodation are to be made electronically only. When funds are electronically transferred from student to host family, the time period the payment covers is to be included in the description of the payment.
1. International Student Personal InformationFirst Name: / ______/ Family Name: / ______
Date of Birth: / ______/ Gender: / Male Female
Nationality: / ______
Home Address: / ______
Home Telephone Number: ______
Fax or Mobile Number: ______
Email Address: ______
Next of Kin
Name & Telephone number: ______
2. Study details
Date due to arrive in Darwin: ______
Date Commencing Study: ______Departure Date: ______
Name of Program of Study:
Senior Secondary Years 10 – 12
Intensive Secondary English Course
Study Abroad Program
Short Term Program
3. Homestay Accommodation Required
If you are not living with a direct family member, provide the name and address of your Australian Guardian (applicable for all students under 18):
Have you stayed in a Homestay Accommodation before: Yes No
If YES, where and for how long? ______
4. International Student Profile
4.1 What activities or hobbies do you enjoy?
4.2 Do you participate in any community organisations in your home country?
4.3 Do you affiliate with a particular religion? If so, which one?
4.4 What is the main language you speak at home?
4.5 Do you speak any other languages?
4.6 Do you have any pets? If yes how many, and what kind?
4.7 Would you be happy to live with a family who own a pet if:
(a) The pet(s) stay outdoors at all times? Yes No
(b) The pet(s) also come indoors? Yes No
4.8 Do you smoke?
4.9 Would you be willing to live with people who smoke?
4.10 Do you suffer any chronic illnesses? Please specify the nature of the illness and/or medication needed.
4.11 Do you have any allergies? Please specify the nature of the illness and/or medication needed.
4.12 Do you have a disability? Please specify the nature of the illness and/or medication needed.
4.13 Do you have any dietary requirements? Please specify.
4.14 What sort of chores do you do at your own home?
4.15 How do you usually travel to school?
4.16 Please describe the characteristics of the homestay family that would best fit your personality?
4.17 Do you have any concerns about living with a homestay family? If yes, please describe these concerns.
4.18 Do you have any other comments you would like to make?
Parent’s Signature: ______Date:______
Parent’s Name: ______(Please Print)
NT Department of Education
International Education Unit
GPO Box 4821
DARWIN NT 0801
CRICOS Provider No. 00780M
Homestay Accommodation Agreement
The NT Department of Education, through International Education Unit will provide accommodation and welfare arrangements for students as requested by parents that do not have a relative residing in the NT whom meet the Department of Immigration and Border Protection (DIBP) requirements.
An overseas student living in an approved homestay accommodation can expect the following services and conditions:
1. A key to the house in which they are living.
2. A bedroom with a bed; bed linen; a desk/table with sufficient light or lamp for study; a chair; cupboard space.
3. Cleaning. Students are responsible for cleaning their own bedroom and participating in the household chores, e.g. washing dishes, putting out the rubbish, cleaning the bathroom.
4. Meals. If full board and lodging has been arranged, the homestay family will supply breakfast and a cooked dinner. The homestay host will ensure that the student has access to fresh and adequate food to make their own breakfast (and lunch on weekends and holidays).
5. Telephone. The student is responsible for the payment of all telecommunications, for example, telephone calls where applicable, facsimile messages, Internet usage, made by the student. The amount payable by the student is the actual amount charged by the Telecommunications Company. This will be detailed on the account. Incoming calls at reasonable times of the day should not be a problem, but students should discuss this with their homestay family.
6. Compensation for any damages. The student is responsible for any damage they may cause to the homestay accommodation. If they damage something, they must pay for the damage if the host family requires it.
7. Orientation for student. Homestay family will give the student a general orientation to the local area and community facilities available, including the public bus system.
8. The cost for full board – The current cost of homestay accommodation is AU$270.00 per week (this includes an air-conditioned bedroom and 2 meals a day during school days and 3 meals a day will be provided on weekends and public holidays). The student must make homestay payments every 2 weeks, in advance. The homestay will issue the student a receipt, which shows the date and amount of the next payment. Payments for Homestay Accommodation are to be made electronically only. When funds are electronically transferred from student to host family, the time period the payment covers is to be included in the description of the payment.
9. There is a holding fee of AU$50.00 per week while the student is away from the homestay accommodation during school stand-down time. However, if the student leaves the homestay accommodation during school semesters (minimum 1 week duration) then the homestay family can ask for up to 50% of the weekly amount.
10. The student is required to give two weeks’ notice when they leave the homestay or to pay two weeks board in lieu of notice.
11. The student does not have exclusive possession of any part of the homestay accommodation and as such may not remove any of the property from the premises without the homestay host’s written consent.
12. The student must obtain the approval of the homestay host prior to bringing any of their friends to visit whilst in the homestay accommodation.
13. The student is unable to keep pets whilst in the homestay accommodation.
14. The student must not be noisy, disruptive, or create any nuisance in the homestay accommodation.
15. If the homestay host has a genuine reason and wishes to cancel the homestay arrangement after the minimum period, the homestay host must give the student two weeks’ notice of termination in writing.
16. The homestay host must reimburse any money owing to the student before the student leaves the homestay.
17. The homestay host will make available to the student soap, toilet paper, and laundry powder. Provision of other items may be negotiated.
18. The homestay host will facilitate a friendly and relaxed atmosphere in their home and treat the student as they would any other member of their family.
19. In the case of medical and police emergencies, it is the responsibility of the homestay host to contact the appropriate emergency services. During business hours the International Student Officer at the school should also be contacted and advised of the situation.
20. Problems. If problems do occur, the first thing to do is to try to resolve them by talking with the homestay host. If this is unsuccessful, students can make contact with the International Student Officer at their school. If this is also unsuccessful with resolving the situation then you should contact the International Education Unit, either the Manager International Education Unit on 8999 5895.
21. Homestay Fees
· First Airport pick up for Student is free of Charge
· Homestay Accommodation Fee
AU$270.00 per week - which includes two meals per day and your own room during school days. (Plus lunch on weekends and public holidays) however, families may charge more depending on the services they provide. Payments for Homestay Accommodation are to be made electronically only. When funds are electronically transferred from student to host family, the time period the payment covers is to be included in the description of the payment.
· Room Retention
AU$50.00 per week – when you are absent from your homestay accommodation during stand-down time. Homestay families can ask for up to 50% of the weekly board if the student is away from the homestay during school semester time (minimum – 1 week).
22. Homestay Visits. Premises are visited and inspected by International Education Unit regularly to ensure that standards are being met.
23. Homestay hosts. They take on care and support role of students under 18 years old and facilitate communication between the student, schools, the Department and parents. They provide care and support for students and assist students to settle into life and study in a NT government school.
24. Working With Children clearance cards. Recognising the importance of child protection, Homestay Providers and Homestay Hosts ensure that all family members living in the home over the age of 15 have a current Working with Children clearance card.
Signature of Student Signature of Homestay Host
Date: ______Date: ______
Signature & Date of Witness Signature & Date of WitnessNT Department of Education
International Education Unit
GPO Box 4821, DARWIN NT 0801
Telephone: 08 8999 5895
Last Updated: February 2017 CRICOS Provider No 00780M