Homestay Application Form

Step 1 of 6

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Host Details

Title(Required)

First Name(Required)

Family Name(Required)

Date of Birth (DOB)(Required)

DD slash MM slash YYYY

Occupation(Required)

Spouse/Partners First Name(s)

Spouse/Partners Family Name

Spouse/Partners DOB

DD slash MM slash YYYY

Occupation

Marital Status(Required)

Address including postcode(Required)

Host (1) Mobile Number(Required)

Host (1) Email Address(Required)

Host (2) Mobile Number

Host (2) Email Address

Household members

Family at Home/ Other Household members

Relationship

Full Name

DOB

Household Pets(Required)

Host (1) Nationality(Required)

Host (2) Nationality

Mother tongue/other language(s) spoken at home(Required)

Family Religion(s)(Required)

Host Family Interests(Required)

Please tell us something about you and your family(Required)

In compliance with British Council standards for safer recruitment, please provide contact details for 3 references. Referees cannot be family members or other residents at the same address.

Referee 1(Required)

Name:

Phone Number

Referee 2(Required)

Name:

Phone Number

Referee 3(Required)

Name:

Phone Number

How did you hear about Anglo-Continental?(Required)

DETAILS OF ACCOMMODATION

Student Room 1(Required)

(Required)

En-suite

Shared Bathroom

Student Room 2

En-suite

Shared Bathroom

Student Room3

En-suite

Shared Bathroom

Student Room 4

En-suite

Shared Bathroom

Declaration regarding suitability to foster children privately. Children’s Act 1989 (part IX)

It is particularly important that we make careful arrangements for the accommodation of students, especially those under the age of 18 years for whom we have special responsibilities under the Children Act 1989.

While you are hosting a student, it is your responsibility to ensure that every member of your household who is 16 years and over has responded to the following questions:

Has any member of the household aged 16 years or over ever:

Been convicted of any offence against a child?(Required)

Yes

Had a child removed from your care by order of any court?(Required)

Yes

Had registration under Part X of the Children Act 1989 refused or cancelled?(Required)

Yes

Had your rights and duties with respect to any child vested in Local Authority?(Required)

Yes

Had a prohibition imposed upon you at any time?(Required)

Yes

Been disqualified from acting as a foster parent?(Required)

Yes

If you have answered ‘yes’ to any of the above questions, please supply the dates and circumstances below.

Section 70 (a) of the Children Act 1989 provides that a person who makes any statement in the notice or information which he/she knows to be false or misleading, shall be guilty of an offence and liable on summary conviction to a fine not exceeding level 5.

I agree that the above details are correct, and that the Local Authority or Anglo-Continental, can access if necessary, through the Disclosure and Barring Service (DBS) information relating to any criminal records held by the police or other government departments, on myself and all members of the household aged 16 years and over.(Required)

Yes

Have you or anyone in your family ever been convicted of a criminal offence, other than a traffic violation?(Required)

Yes

If yes, please give further details:

Do you or anyone in your family have any medical conditions that would affect your ability to host students? If yes, please give further details:(Required)

Yes

If yes, please give further details:

DETAILS OF ACCOMMODATION CONTINUED

I agree to the following:(Required)

I will ensure my home will be suitably clean and tidy for the duration of the student’s stay

I will help my student to feel like part of our family

I will allow my student to take a daily bath or shower

I will not host more than 4 students at one time (including students from other schools)

I will not host students of the same mother tongue (unless specifically agreed with Anglo-Continental)

I will give my student clean bed linen and towels weekly

I will provide my student with laundry service once per week

I will ensure that my student will eat with the family

I will provide well-balanced and adequate meals, and they will include lunch at weekends and on bank holidays

I will enforce curfew times for my under 18 year-old students in line with Anglo-Continental’s rules

I will not take payments directly from my students unless specifically agreed with Anglo-Continental

I understand and agree with the following:

I confirm that I have read and accept the ‘Conditions for the Provision of Homestay Accommodation’. www.anglo-continental.com/homestay.html
I confirm that I will update my Gas Certificate, Risk Assessment and Child Act form on annual basis and any other necessary documentation when requested.
The information that I have provided is accurate and complete.
I agree to all rooms in my house being seen by the Viewing Representative at every scheduled viewing.
I agree to my homestay being reviewed every 18 – 24 months and will notify the school of any relevant changes.
I understand, that by registering to be a homestay family with Anglo-Continental, I agree to my contact details and information about myself and family members being shared with Anglo-Continental representatives and students that I will be hosting.
In compliance with GDPR, I give Anglo-Continental consent to retain and update my information electronically until I put in writing that I no longer wish to host students for Anglo-Continental.

Yes

HOMESTAY FAMILY BANK DETAILS

Name of Bank/Building Society(Required)

Account Holder’s Name(s)(Required)

Sort Code(Required)

Account Number(Required)

Thank you for completing our form. Do you know if you recommend a friend, you can earn £80? Please ask the viewing representative for more details.

Homestay Handbook for students aged 18+ 2024