Farmstay Application Form

Parent Host Names

Title

First Name *

Family Name *

Occupation

Mobile Phone

Add Remove

Address

No and Street *

Suburb

City *

Post Code *

Contact Details

Email *

Confirm Email *

Confirm

Phone

If No landline enter main mobile contact

Others in the home

Are there other members in the household

No others in the home

Yes other people in the home

Others in the home

Name

Relationship

Date of Birth

Interests and Hobbies

School Attending

Add a member Remove

Family Pets

Do you have pets in your home?

Yes

Please provide pet details

Family Description

Please add a paragraph about you and your family for your profile

Section

Farm Size *

What size is the property?

Farm Description *

Family Photos and farm photos

Check to attach photos

Click to attach

Attach Family photos

Maximum upload size: 2.1MB

Up to 3 photos can be attached. File format .jpg .gif .png

Bank account number for host payments

Let’s Homestay Host Family Conditions

Checkboxes

I agree to the Lets Homestay Host Family Terms and Conditions

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If you are human, leave this field blank.