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Homestay Application Form

eStudent London
Unit 8 - 16 Chestnut Grove
London SE20 8PF

Tel: 020 3006 5299

Email: info@estudentlondon.com
Website: http://www.estudentlondon.com

Name

Surname

Full Home Address

Country

Telephone

Mobile

Email

Nationality

Date Of Birth

dd/mm/yyyy

Gender

Male
Female

Smoking

Yes
No

Preferred Homestay Type

Standard Zone 4/5
Standard Zone 3
Standard Zone 2
Standard Zone 2/1

Preferred Meal Plan

Bed & Breakfast Only
Bed, Breakfast & Dinner
Self-Catering

Room Type

Single
Twin

Do You Like Animals?

Yes
No

Would You Be Happy To Live In A Household With Children?

Yes
No

Are You Vegetarian?

Yes
No

Are You Diabetic?

Yes
No

Do You Have Allergies?

Yes
No

If you have answered yes to the above questions please enter details below

School/Area Where You Will Be Studying

Please enter your school name or the nearest underground station

Period of stay

Date Of Arrival

dd/mm/yyyy

Date Of Depature

dd/mm/yyyy

Airport Pick-Up

Would You Like To Be Picked Up At The Airport?

Yes
No

Please Enter Your Flight Arrival Date

dd/mm/yyyy

Flight Number

Landing At Which Airport?

Please select from the list

Any Other Information

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