Kanazawa Seiryo University - 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?*
- Full Board (3 meals per day)
- 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
Your arrival date
When does the plane arrive in Perth?
DD dash MM dash YYYY
Arrival time
What time does the flight arrive in Perth? 到着時間

Hours :

Minutes

AM/PM
Flight number
What is the flight number this group will be arriving on?
Your departure date
When does your plane leave Perth?
DD dash MM dash YYYY
Departure time
What time does the flight leave Perth?

Hours :

Minutes

AM/PM
Departure Flight number
What is the flight number this group will be departing on?

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

Kanazawa Seiryo University – Aug 2025