Registration Form

Registration Form for Homestay Accomodation

+64-9-620-9393

info@dtours.co.nz

1/3 Lynfield Place ,Mt Roskill,1041

New Zealand

Proudly made by Casa Infotech

Reference NO.(Offer of Place)
Agent's Name and Contact
Date of Application
Section-A: This section must be completed in full before the application can be processed.
Student
First Name (required)
Family Name (required)
Date of birth(required)
Sex	MaleFemale
Nationality
Occupation
Your Email (required)
Contact (required)

Section-B:
Travel Details(if known)
Arrival Date
Time
Flight
Study Details
Course of study, Place and date of commencement
Homestay Accomodation
Number of weeks required
Do you smoke?	YesNo
Are you Vegetarian?	YesNo
Is there any food you cannot eat?	YesNo if yes,give details
Do you have any medical problem/allergies?	YesNo if yes,give details
Do you have any special religious observances?	YesNo if yes,give details
Most new Zealand families have pets. If you are allergic to animals, please let us know	YesNo
What hobbies/sports/interests do you enjoy?
Do you prefer a family with no children?	with children under 12?with children over 12?with other international students?any of the above?