Applicant details
First Name (required) Family Name (required) Age (required) Nationality (required) Mother Tongue (required) Address (required) Post Code (required) Telephone (required) Mobile (required) Work Telephone (required) Email (required)
Partner details
First Name Family Name Age Nationality Mother Tongue
Details of children / other family members
Name Age Gender At home/not
Other details
Please give details of any domestic pets including breed of cats and dogs: (required) Does anybody at your house smoke? (required) Is your family vegetarian? (required) Would you host a vegetarian? (required) Are there any unusual family circumstances or medical problems? (required)
Your home / house details (please tick/fill in where applicable)
TerracedSemi-detachedDetachedBungalowFlatOther
Total number of bedrooms? (required) Do you have dining area? (required) Do you have sitting room? (required) Total number of bathrooms? (required) Number of toilets? (required) Do you have central heating? (required)
Students (Please tick/fill in where applicable)
Room 1 SingleTwin sharedTwin aloneDouble aloneWardrobeDrawer spaceDesk/tableTV
Room 2 SingleTwin sharedTwin aloneDouble aloneWardrobeDrawer spaceDesk/tableTV
Room 3 SingleTwin sharedTwin aloneDouble aloneWardrobeDrawer spaceDesk/tableTV
Facilities available to student(s)
Do students have exclusive use of any of the bathroom, shower and toilet facilities? (required) Regular laundry service? (required) Provision of key? (required) Place for private study, with chair? (required) Access at all times to the sitting room? (required) Telephone for incoming calls? (required) GardenTVDVDPCWi-Fi Half boardSelf catering Any other facilities available for students?
Travel Information
Which bus routes can be used to travel to and from Hove Town Hall? (required) What is the approximate journey time to the Hove Town Hall by bus? (required) How far is your house from the nearest bus stop? (required)
Hosting Preferences
Number of students Sex Age Any restrictions?
Confirmation
Please tick here if it would be acceptable to pass your details on to a third party when we are legally obliged to do so (for example a criminal record check or accreditation bodies)? Please note that this is very important for students’ welfare and it may affect our decision to lodge students with you. (required)
Any other information?
I confirm the details above are true. I have read and agree to the terms.
Signed (required) Name in CAPITALS (required) Date (required)
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