Student Application form
Application for a stay abroad
Email address *
Home address in full *
Your answer
Student's Name *
Your answer
Student's Date of Birth + Gender *
Your answer
I want to apply for *
Mother's name and Occupation *
Your answer
Mother's Mobile Phone Number *
Your answer
Father's Name and Occupation
Your answer
Father's Mobile Phone Number
Your answer
Student's Mobile Phone Number *
Your answer
Landline/Emergency Contact Number *
Your answer
Student's Hobbies *
Your answer
Is this your childs first time to travelling away from home alone? Yes or No *
Your answer
Allergies or Illnesses *
Your answer
Student nationality + First language *
Your answer
Preferred Travel dates
Your answer
Do you require airport transfers, Yes or No: Please note mandatory for students <16y *
Your answer
Any other relevant information
Your answer
Name of Person completing the application and relationship to the student *
Your answer
We consent to and authorise Chez Nous Homestay (CNH), its representatives or the host family, to act in our place and to sign on our behalf for any emergency procedures required in the event of an accident or other emergency and pay all expenses for any treatment or procedure undertaken. We give permission for our child to exit his/her home country . We confirm that there is no reason whatsoever that the person seeking the homestay programme is unsuitable for the programme requested. We have read and agree with the general conditions of CNH *
Required
Please note that some countries require parents/guardians to complete a consent form so their child may travel unaccompanied. *
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