Homestay Host Application Form

Excel College, St James Building,

89 Oxford Street, Manchester, M1 6FQ

Tel 0161 236 5551

Homestay Host Application Form

Please read through the homestay host guidebook before completing this application form.

Personal Details
First Name / Surname
Title / Date of Birth
Nationality / Marital Status
Occupation / Religion (if any)
Email / Home Telephone Number
Mobile Telephone Number / How do you prefer to be contacted?
Home Address
Household Members’ Details
Name / Date of Birth / Relationship to you / Occupation
Information about you your home
Type of home?
e.g semi detatched, flat ect.. / Number of rooms available?
Do you have a gas safety certificate?
dated within the past 12 months / Yes ¨ No ¨ / Is English the main language spoken in the home? If no, please give details / Yes ¨ No ¨
Do you have any pets?
If yes please give details / Yes ¨ No ¨ / Is there a study areaavailable to students? / Yes ¨ No ¨
Your availability to host (all year/summer/winter ect) / Do you have smoke alarms fitted? / Yes ¨ No ¨
Local transport into Manchester city centre please give details & accurate travel time
Have you hosted international students before?
please give details
Do you, or does anyone in your home, have any criminal convictions?
If yes, please give details
Any other relevant information?
Your Preferences
Would you be happy to accept students under 18 years old? This would only be 16 – 17 years old / Yes ¨ No ¨ / Do you hold a DBS certificate dated within the last 3 years?
Previously CRB / Yes ¨ No ¨
Could students have friends come to visit? / Yes ¨ No ¨ / Would students be given keys to the house? / Yes ¨ No ¨
Would you be able to provide breakfast and dinner each day? / Yes ¨ No ¨ / Are you able to cater for special diets? e.g. halal / Yes ¨ No ¨
Types of student accepted / Male ¨ Female ¨ Couple ¨ Smoker ¨
Would the student have access to the following? / WIFI ¨ Computer ¨ TV/DVD ¨
Communal Areas ¨ Kitchen ¨ Washing Facilities ¨
Telephone ¨
Any other preferences you think we may find useful?
Please write a short paragraph, of maximum 100
words, in which you introduce you and your family to a potential student

Criminal record Notice

- It is important that applicants understand that failure to disclose all criminal convictions for either themselves or other household members will result in their application being withdrawn.

Safeguarding statement (for hosts accepting students under 18 years old)

- Excel College is committed to the safeguarding of under 18s. All adults associated with the college are expected to share the college ethos and actively engage in looking after under 18s safely.

- Recruitment of hosts for students under 18 years old is subject to an enhanced DBS check, two satisfactory references and the completion of basic safeguarding training.

Data Protection notice

- By submitting this application form to Excel College, the prospective host agrees to the storage of their personal details in the College’s administrative systems, whether on paper, computer or any other medium and to the usage of that information for Excel College’s purposes only.

- All personal details and any other information provided to Excel College will be processed in accordance with the ICO data protection registration and with the provisions of the relevant national legislation (with particular reference to the Data Protection Act 1998).

- Excel College shall not supply any personal information provided by the host to any third party other than the student(s) to be hosted.

- It is the host’s responsibility to keep Excel College informed of any changes of home address, mobile phone number and email address, as well as changes to banking details.

I declare that the information contained in my application is correct to the best of my knowledge. I understand that any false statement may result in my application being withdrawn.

PRINT NAME ______DATE______

SIGN NAME ______

Thank you for taking the time to complete the the homestay host application form.

Please return the completed form and a copy of your gas safety certificate to the accommodation officer at Excel College, either by email or post.