About Us
Contact Us
Guest Application Form
Personal Details:
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Indicates required field
Name
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First
Last
[object Object]
Gender
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Male
Female
Date of Birth (e.g. 14 January 1985)
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Phone Number 1
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Phone Number 2
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Email
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Home Address
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Line 1
Line 2
City
State
Zip Code
Country
Nationality
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Languages Spoken
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Level of English
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None
Beginner
Intermediate
Advanced
Native Speaker
Religion (if any)
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Do you smoke?
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Yes
No
Do you have any special dietary requirements?
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Is there any food that you do NOT eat?
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Do you have any medical conditions or allergies?
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Yes
No
If yes, what is the condition/allergy?
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Homestay Request:
Where are you living now?
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Swansea
UK (not Swansea)
Overseas
Homestay arrival (e.g. 13 July 2016)
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Homestay Departure (e.g. 30 October 2016)
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Which homestay would you prefer?
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Homestay for under 18 year old: Price on application
Short-stay (up to 2 weeks): Price on application
No Meals: £104 pw
Breakfast Only: £114 pw
Breakfast & Evening Meal: £128 pw
Breakfast, Packed Lunch & Evening Meal: £142 pw
Would you like a private bathroom (£13 extra pw)
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Yes
No
Please note, there is also a £75 booking fee
Would you like a homestay with children?
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Yes
No
Don't mind
Would you like a homestay with pets?
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Yes
No
Don't mind
About You:
Describe at least 5 of your hobbies/interests:
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Describe your personality (in at least 20 words)
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Describe your ideal host family
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Do you have any special needs/requests?
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What will you be doing in Swansea?
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Student at College (age under 18)
Student at Language School
Student at University (undergraduate)
Student at University (postgraduate)
Visiting Academic
Medical Placement
Internship
Student at Bible College
Other
If 'other', please give details:
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Provide address of study / workplace
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Provide name of course or work programme
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Emergency Contact Details
Name
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First
Last
Relationship to you
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Parent
Other Relative
Family Friend
Email
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Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
I understand that all information supplied is correct to my knowledge at the time of writing and any misinformation may result in the forfeit of the Homestay booking without refund of fees.
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Yes
I give permission to Swansea Homestay to contact me regarding services they can offer
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Yes
More information on our Privacy Notice can be found at: www.swanseahomestay.com/privacy-notice
IMPORTANT MESSAGE FROM SWANSEA HOMESTAY:
You will hear back from us within 48 hours. If you do not then it is important that you check we have received your Application Form by emailing us on: info@swanseahomestay.com
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