Deakin Application Name of Agent Email address of Agent Name of Agent's Contact person Student details Family name Given name Preferred name / English name Date Of Birth Age Gender MaleFemaleTransgenderGender neutralNon-binaryOther Nationality What Provence/City do you reside in Student Email address Parent Email address (Required for invoicing purposes) Caregiver Company Do you smoke: YesNo Date of Arrival Time of Arrival Flight Number Do you require transport from the airport to the homestay? (Compulsory for students under 18) YesNo Homestay Start Date How many weeks do you require homestay? (4 weeks is the minimum stay) What area of Deakin do you commence your studies? Deakin CollegeDUELI Deakin Campus BurwoodWaurn PondsWaterfront Course Start Date Do you have any food allergies and/or dietary requirements? Details: Please list your Food Allergies and/or Dietary Requirements here. Any Medical Details we need to know about? Please list your Medical details here. Homestay Information Please note you will be placed in the best homestay available at the time of your application Smoking (Outside Only) YesNo Other students YesNoDon't Mind Other Children YesNoDon't Mind Pets YesNoDon't Mind Message Please leave this field empty. Δ Payment Details: You will receive an invoice for the placement fee and the first four weeks accommodation shortly. Payment details will be on the invoice.
