Request for Accommodation 2014 WE WILL DO OUR BEST TO ACCOMMODATE THE REQUESTS MADE BUT CANNOT GUARANTEE TO MEET ALL OF YOUR REQUIREMENTS.
Family Name: ___________________________Given Names: ____________________________________________________ Student ID [if available]: ______________________ Gender: Male
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Female 0
Date of Birth:
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(dd/mm/yy)
Nationality _____________________ Telephone: ______________________ Email: _________________________________ (Include country and area code)
Home Address: __________________________________________________________________________________________ Course:
_____________________________ Course start date: ________________ Course end date: __________________
Agent Name: ______________________________________ Agent Email: __________________________________________ (if applicable)
UNDER 18 STUDENTS – Guardianship Requirements - THIS SECTION MUST BE SIGNED BY THE STUDENT’S PARENTS. I / We request that SAIBT / CELUSA arrange Guardianship for my child (under 18 years) and also understand that to issue a Confirmation of Appropriate Accommodation & Welfare (CAAW) document my child must live in an approved Homestay or Under 18 Student Residence.
Parent(s) Name: ___________________________ Parent(s) Signature: ___________________________
Date:
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Parent(s) Name: ___________________________ Parent(s) Signature: ___________________________
Date:
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Do you suffer from any medical conditions? Eg: Hepatitis
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Asthma
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TB
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No Epilepsy
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Yes Diabetes
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(if yes, give details) Other (please explain)
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Details of any medical condition: ______________________________________________________________________________ Do you have any other allergies or special needs? _____________________________________________________________
ACCOMMODATION OPTIONS FOR STUDENTS UNDER 18 Homestay: Full Board Homeaway Fully Supervised Full Board Student Residence for Under 18
Cost per week $240. $292
Tick to choose option
Meals
Facilities
All meals except lunch on school days All meals 7 days per week
Own room, access to common areas
All meals except lunch on school days No meals provided
Own room, access to common areas
Own room share bathrooms, access to common areas and laundry
FOR STUDENTS OVER 18 Homestay: Full Board
$240
Homestay: Part Board
$150
Student Residence: Full Board
$240 - $290
Student Residence: Part Board
$130 - $150
Student Apartments:
City location / fully furnished / 6 or 12 months lease
Single or Double Studio Room
$202 - $430
No meals
Own room with all facilities
Single Room in Shared Apartment
$250 - $375
No meals
Own room with ensuite bathroom, share common areas
Own room, access to common areas including kitchen 10 - 30 mins from city, own room, share bathroom own room, share bathrooms
All meals 7 days per week No meals provided
THE FOLLOWING QUESTIONS MUST BE COMPLETED BY STUDENTS REQUESTING HOMESTAY ACCOMMODATION. What length of homestay do you require? From: ___________________________ to: _____________________________ (The minimum length of homestay is 5 weeks)
Do you smoke?
No
Do you prefer a family with pets?
No
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Yes Yes
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The majority of Australian families have pets (usually a dog and/or a cat), if you tick ‘No’ to the above question, we cannot guarantee you a homestay without pets. If you have an allergy or are particularly frightened of animals, please indicate below:
_____________________________________________________________________________________ Do you prefer a family with children? No If yes, do you prefer: Older children
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Yes Younger children
Are you happy to live in a Homestay with other international students? (Most Homestays accommodate 2-3 students but priority is given to different nationalities)
No
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Do not mind Yes
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Please list any foods you do not eat or any dietary requirements:
______________________________________________________________________________ What are your hobbies / interests? Do you play or are you interested in any sport?
______________________________________________________________________________ ______________________________________________________________________________ Please tell the homestay host a few things about yourself, your family, the place where you live, what you hope to achieve while you are in Australia?
______________________________________________________________________________ ______________________________________________________________________________ AIRPORT RECEPTION WILL BE ARRANGED WHEN ARRIVAL DETAILS ARE COMPLETED: Date of Arrival in Adelaide:
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Day: ___________________Time: ___________________Flight No: ____________________Airline: _______________________ (Flight Arrival Details should be forwarded as soon as available - ideally 2 weeks prior to departure)
If relatives or friends are arriving with you please supply their name, relationship to you and where they will stay in Adelaide.
______________________________________________________________________________ ______________________________________________________________________________ ACCOMMODATION AGREEMENT As a participant in the SAIBT / CELUSA Accommodation Program, I understand that: (tick appropriate boxes) In Homestay, I will: 0 pay a $300 bond. I understand this is refundable in full within 1 week of leaving the homestay, as long as there are no damages, unpaid homestay fees or money owing for phones accounts etc 0 make my homestay fee payments regularly, two weeks in advance 0 stay in the homestay for the minimum stay as indicated in the letter of confirmation and give 2 weeks notice to the host family if I decide to leave 0 behave in a manner respectful of my homestay host’s values, reflecting positively upon my family, my homestay host and SAIBT / CELUSA 0 be a co-operative and contributing member of my homestay and participate in family life by joining the family for meals, outings and other activities when invited 0 not ask my homestay host to accommodate any relatives or friends on arrival or during my stay in the homestay 0 abstain from the excessive use of alcohol or not consume alcohol (if under 18) and not bring alcohol into the homestay without permission 0 not possess or use prohibited or dangerous weapons or illegal drugs 0 not borrow money from my host family In a Student Residence, I will: 0 remain at the residence for the agreed period and pay my rent and bond as required 0 give appropriate notice in advance if I decide to leave 0 follow the rules and regulations of the residence 0 behave in a respectful manner which reflects positively upon my family and SAIBT / CELUSA 0 abstain from the excessive use of alcohol or not consume alcohol (if under 18) 0 not possess or use prohibited or dangerous weapons or illegal drugs Change of Address: I understand that I must inform SAIBT / CELUSA of any changes to my address or contact details while living in Australia. This is a Department of Immigration and Border Protection (DIBP) requirement for Student Visa holders. Students Under 18: I understand that changes to my accommodation MUST be negotiated with the Accommodation Office. I declare all information provided with this form is correct. I have read and understood the Accommodation Agreement. Student Signature: ___________________________ Student Name: ________________________Date:__________________ (Please Print)
Fees:
Accommodation Placement Fee (includes airport reception) Guardianship Processing Fee
$305.00 $500.00
(These fees can be paid with Tuition Fees)
Please return this form to: SAIBT / CELUSA Accommodation Office Brookman Building, City East Campus UniSA, North Terrace, Adelaide, South Australia, 5000 Email:
[email protected] Phone: (+61 8) 8302 1027 CRICOS Provider Number 02193C
[Updated November 2014]