Aichi Gakuin University Group "A" - 6 Aug 2025 - UWA Study Tours - Student Homestay Application

About this student
This field is hidden when viewing the form
Is this student part of a study group?*
- Yes
- No
Study group name*
Study group contact person*
School, University or College attending in Perth?*
留学予定の学校名
Type of Homestay required?*
- Traditional (Breakfast and dinner weekdays and 3 meals on weekends)
Student Name*
名前
First name Family Name (Surname)
Student email address*
メールアドレス
Student gender - Male o男 Female o女 or Other (please describe)*
- Male
- Female
Student date of birth*
誕生日（日・月・年）
DD dash MM dash YYYY
When would you like accommodation from?
いつからの宿泊を希望しますか?
DD dash MM dash YYYY
When do you require accommodation to?
いつまで必要ですか？
DD dash MM dash YYYY
Airport pickup by Talkabout Tours?
- Yes
- No

Some more student details
Let us know some of the finer details about you so we can match with the perfect home.
Your address
現住所

Street Address Address Line 2 City State / Province / Region Country
Your mobile phone number
携帯電話番号

Aichi Gakuin University Group “A” – 6 Aug 2025