Please fill out the form below if you are interested in becoming a SELC Homestay.

First Name (required)

Last Name (required)

Street Address (required)

Suburb (required)

Your Email (required)

Home Phone

Work Phone

Mobile

Please provide a brief summary of family members in the household:

Type of accommodation you are offering:
SingleTwinDoubleHalf-board (breakfast & dinner provided)Room & Facilities

Have you ever hosted an international student before?
YesNo

If yes, please give details:

Any comments or questions?