Student Application Form

Are you an agent/school official that is applying on behalf of your student?*

Please provide your name

Please provide your email

Student/Intern Detail

If you are a school official or an agent applying for your student, please provide your student's detail below.

First Name*

Middle Name

Last Name*

Preferred Name/English Name

Nationality*

Birthday*

Gender*

Male
Female

Please enter your valid ID Number (Passport No. or Drivers license)

Please upload your valid ID (Passport/Drivers license)

Max. file size: 64 MB.

Please upload your valid visa if you are international students/interns/visitors

Max. file size: 64 MB.

Where are you travelling from?*

Mobile Number*

Email*

Home Address*

City*

State

Zipcode/Postcode

Country*

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Accommodation Location

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Accommodation Location

Which city do you require a homestay?*

What is the purpose for your visit?*

Which school/university will you be attending?

What course will you take?

Course start date

Course end date

School/University Address

Which organisation will you do your internship with?

Please provide the organisation address

Please provide your internship schedule, e.g. I will be working from 9 to 5, Monday to Friday

Please provide your sightseeing schedule, e,g. places you will be visiting and the date

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Please select the homestay type*

Budget homestay (small bedroom, share bathroom with host families
Standard homestay (resonable size of bedroom, share bathroom with host families )
Homestay plus (good size of bedroom, own bathroom or shared bathroom with one other student)

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If you are applying homestay in Auckland or Wellington, do you request a central homestay? The additional cost will be $30 extra per week*

YES
NO

If you choose a central homestay, you will be placed in a homestay which allows you to commute from your homestay to school/company/the place you want to visit by direct bus/train within 40 minutes (including walking).

Accommodation start date*

Accommodation end date*

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Accommodation Type*

Single Room
Shared Room

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Do you require lunch from Monday to Friday?

YES
NO

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Meal Plan*

Half Board (Mon-Fri - Breakfast and dinner ; Sat-Sun - Breakfast, lunch and dinner)
Full Board (Mon-Sun - 7 Days - Breakfast, lunch and dinner)
No Meal

Meal Plan*

Half Board (Mon-Fri - Breakfast and dinner ; Sat-Sun - Breakfast, lunch and dinner)
Full Board (Mon-Sun - 7 Days - Breakfast, lunch and dinner)

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Would you like internet access?

YES
NO

Are you happy to stay in a home with pets (Please note we will try our best to meet your preference however, this is not guarenteed)?*

YES
NO

If yes, please state your preferred pets

Please note we will try our best to meet your preference but it is not guaranteed

If no, are you allergic to any pets?*

What pets are you allergic to?*

Are you happy to stay in home with kids (Please note we will try our best to meet your preference but it is not guaranteed)?*

YES
NO

If yes, please state your preferred age

Do you smoke?*

YES
NO

Do you vape?*

YES
NO

Would you mind staying with smokers (Please note we will try our best to meet your preference but it is not guaranteed)?*

YES
NO

Do you have any food allergy?*

YES
NO

If yes, please state the food that you are allergic to*

Do you have any dietary requirement (Please note there will be extra charge on the specital dietary)?*

Yes
No

If yes, please provide details*

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Do you have any dietary requirement?*

Do you have any health condition that we should be aware of?*

Yes
No

If yes, please provide details

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Do you have any symptoms of Covid-19, e.g. cough, sputum, shortness of breath, fever, etc?*

Yes
No

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If yes, please provide details

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Are you fully vaccinated (Covid)?

Yes
No

In order to ensure the safety of the student and host, we require all students to declare their Covid vaccination records

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If no, please provide details*

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Please upload your Covid vaccination pass?

Max. file size: 64 MB.

Do you require regular medication?*

Yes
No

If yes, please provide details*

Does your religion require any special attention?*

Yes
No

If yes, please provide details*

Do you have any other special request (Please note we will try our best to meet your preference but it is not guaranteed )?*

Yes
No

If yes, please provide details below*

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Do you have any other special request?

Please describe the ideal family you would like to live with and prioritize your preferences, e.g. what is more important to you, distance to school, or living with families with pets or kids. If living with pets or kids is critical to you, please note you might need to travel for over an hour to school. Although we are unable to guarantee to meet your requirements, prioritizing your needs will increase the chance for us to find the best suitable family within the available options.

Please write a brief greeting to say hi and introduce yourself to your host

Do you have valid visa to come to New Zealand?*

Arrival Date*

Arrival Time

Flight Number (Arrival)

Flight Number (Departure)

Do you need Host Families NZ to arrange an airport transfer for you?*

Are you under the age of 18?

Parent/Legal Guardian Name*

Relationship of the Parent/Legal Guardian*

Parent/Legal Guardian Contact Number*

Consent*

I declare that I have the consent from my parents or legal guardian to submit this homestay application

Parent/Legal Guardian Contact Email*

Name of Emergency Contact*

Relationship of the Emergency Contact*

Emergency Contact Number*

Emergency Contact Email*

Are you referred by an agent/school? If yes, please enter their name

Can you let us know what is the reason for you to choose homestay instead of other forms of accommodations? This will help us to improve our service and provide you with the best possible homestay.

Date of Request

Declaration*

Homestay Contract

I authorities Host Families NZ Limited (HFNZL) to look for a homestay accommodation for me. The effective day would be the date that I submit this application.

HFNZL’s responsibilities are:

• Place the applicant with a suitable homestay
• Provide a booking confirmation to the student and host when a placement is made
• Undergo a safety check for all house members that are over the age of 18
• Carry out homestay inspections to ensure all requirements of being a homestay are met and the home is suitable
• Conduct regular visits (at least once a year) to ensure the homestay still meets the hosting standards
• Provide support to students, families, partner schools/agents when issues arise
• Provide 24/7 emergency support to all applicants

I understand the homestay accommodation will include:

• A private bedroom with desk, chair, bed linen, Storage for belongings
• Reasonable use of electricity, water, and the internet is included
• Shared bathroom with host families and students
• Laundry will be available for you to use
• 24 hours Emergency support

I understand the homestay accommodation does not include:

• Any personal expenses incurred by me during my stay including (but not limited to) toilet paper, personal hygiene products, mobile calls, excessive use of electricity/internet/water
• Provide accommodation to my family members, relatives, or friends
• Any damage to the homestay property.

I understand that the homestay accommodation is subject to the homestay’s availability. If my application is successful, I declare that:

• I will be friendly and always respect my homestay family
• I will always follow the laws of New Zealand. I understand failure to do so may result in an immediate termination of my homestay contract
• I will always follow the host family’s curfew times and homestay rules/guidelines that are provided by HFNZL and my homestay family. I understand failure to do so may result in an immediate termination of my homestay contract
• I will keep my bedroom and the bathroom I am using clean and tidy
• I will inform my homestay and get permission before I invite anyone over
• I will be mindful of the use of electricity, water and internet and I agree to pay an extra fee if my usage exceeds the normal usage
• I will inform my homestay if I have any allergies, such as any allergic to pets or food
• I will not smoke cigarettes inside the house and not smoke anywhere at any time if I am under the age of 18
• I will not stay at any other accommodation apart from my homestay if I am under 18 years old unless I have obtained written permissions from HFNZL (This rule only applies to international students)
• I will keep quiet after 10 pm
• I will pay for the homestay fee on time
• I will not cook unless I have permission from my host family. If I am under the age of 18, I understand and agree that I am not allowed to cook at all times.
• I understand the move-in time is after 2 pm on arrival and the move-out time is 10 am on departure. If I arrive earlier than 10 am or depart late than 2 pm, I understand and agree to pay an extra day
• I will give two weeks’ notice to HFNZL if I plan to move out, extend my homestay or go anywhere for a holiday/break
• I will move out of my homestay when my booking finishes. I understand all homestay extensions must go through HFNZL. I will not make any direct payments or negotiate the homestay fee with my homestay family
• When moving out, I will leave my bedroom and the bathroom I am using in a neat condition. I understand and agree to pay a cleaning fee if I fail to do so
• I will be responsible for any damage caused by me during my stay
• I understand and agree that HFNZL is not liable for any loss or damage caused directly or indirectly by the homestay accommodation.
• I understand If I do not follow the homestay rules and guidelines, my homestay contract maybe terminates immediately

I declare that the information provided above is true, complete and correct. I will inform Host Families NZ of any change should it become relevant. I have read and understood the conditions and homestay rules. I agree to abide by them.

Consent

I agree to the privacy policy.

This is the privacy policy of Host Families NZ Limited (HFNZL). By submitting personal information to HFNZL or its service providers/partners, you are giving permissions to HFNZL to collect, use and disclose personal information in accordance with this privacy policy or permitted by law.

In this document, “we”, “our”, or “us” refer to Host Families NZ Limited (NHFNZL). Our New Zealand Business Number (NZBN) is 9429031482899.

This privacy policy aims to inform you about how we collect and handle any information that we collect from you, or that you provide to us. It covers both information that could identify you (“personal information”) and information that could not.

We are extremely concerned to protect your privacy and confidentiality. We understand that all users of our website and service are quite rightly concerned to know that their data will not be used for any purpose unintended by them, and will not accidentally fall into the hands of a third party. Our policy is both specific and strict. It complies with New Zealand law. If you think our policy falls short of your expectations or that we are failing to abide by our policy, do please tell us.

We regret that if there are one or more points below with which you are not happy, you can leave our website immediately or email us at partnership@hostfamilies.co.nz to delete all your information that we hold of. However, in doing so, we may not be able to provide the service you request.

Except as set out below, we do not share, or sell, or disclose to a third party, any personally identifiable information collected at our website.

Here is a list of the information we collect from you, either through our website or because you give it to us in some other way, and why it is necessary to collect it:

1. Business and personal information
This includes basic identification and contact information, such as your name and contact details and also includes all information given to us in the course of your business and ours, such as information you give us in your capacity as our client. We undertake to preserve the confidentiality of the information and of the terms of our relationship. It is not used for any other purpose. We expect you to reciprocate this policy.
In general, HFNZL collects, uses, and discloses personal information from students, parents, schools, agents, partners, host families and any other person that is relevant to operate or delivery our service.
This information is used:

1.1. to provide you with the services which you request; this includes matching students with a suitable homestay, booking pickup/drop off services, conducting designated caregiver assessments, under 18 assessments and any other services requested by you.
1.2. for verifying your identity for security purposes;
1.3. for marketing our services and products;
1.4. information which does not identify any individual may be used in a general way by us or third parties, to provide class information, for example relating to demographics or usage of a particular page or service.
We keep information, which forms part of our business record for as long as necessary to perform, operate and deliver our service.
This information will be shared and disclosed to
1.5. students, parents, agents who request for homestay placements;
1.6. schools and school officials, government agencies, host parents and third providers of HFNZL;
1.7. any other person that you consented or permitted by law

2. Your domain name and e-mail address
This information is recognised by our servers and the pages that you visit are recorded. We shall not under any circumstances, divulge your e-mail address to any person who is not an employee or contractor of ours and who does not need to know, either generally or specifically. This information is used:
2.1. to correspond with you or deal with you as you expect;
2.2. in a collective way not referable to any particular individual, for the purpose of quality control and improvement of our website;
2.3. to send you news about the services to which you have signed up;
2.4. to tell you about other of our services or services of sister websites.

3. Information you post on our website
Information you send to us by posting to a forum or blog or in your advertisement, is stored on our servers. We do not specifically use that information except to allow it to be read, but you will see in our terms and conditions that we reserve a right to use it in any way we decide.

4. Website usage information
We may use software embedded in our website (such as JavaScript) to collect information about pages you view and how you have reached them, what you do when you visit a page, the length of time you remain on the page, and how we perform in providing content to you. We do not presently associate such information with an identifiable person.

5. Financial information relating to your credit cards
This information is never taken by us either through our website or otherwise. At the point of payment, you are transferred to a secure page on the website of PayPal or Kiwi Bank or some other reputable payment service provider. That page may be dressed in our “livery”, but it is not controlled by us. Our staff and contractors never have access to it.

6. Note on padlock symbols and other trust marks
Many companies offer certification and an icon or other small graphic to prove to website visitors that the website is safe. Some certify to a high level of safety. Others are more concerned to take our money than to provide a useful service. We do not handle information about your credit card so do not subscribe to any such service.

7. Credit reference
To assist in combating fraud, we share information with credit reference agencies, so far as it relates to clients or customers who instruct their credit card issuer to cancel payment to us without having first provided an acceptable reason to us and given us the opportunity to refund their money.

8. Third party content
Our website is a publishing medium in that anyone may register and then publish information about himself or some other person. We do not moderate or control what is posted. If you complain about any of the content on our website, we shall investigate your complaint. If we feel, it may be justified, we shall remove it while we investigate. Free speech is a fundamental right, so we have to make a judgment as to whose right will be obstructed: yours, or that of the person who posted the content which offends you. If we think, your complaint is vexatious or without any basis, we shall not correspond with you about it.

9. Information we obtain from third parties
Although we do not disclose your personal information to any third party (except as set out in this policy), we do receive data which is indirectly made up from your personal information, from software services such as Google Analytics and others. No such information is identifiable to you.

10. Content you provide to us with a view to be used by third party
If you provide information to us with a view to it being read, copied, downloaded, or used by other people, we accept no responsibility for what that third party may do with it. It is up to you to satisfy yourself about the privacy level of every person who might see your information. If it is available to the World, neither we nor you have any control whatsoever as to how it is used.

11. Cookies
Cookies are small text files that are placed on your computer's hard drive through your web browser when you visit any website. They are widely used to make websites work, or work more efficiently, as well as to provide information to the owners of the website.
HFNZL do not use any cookies to collect personal information. However, our website server will automatically collect IP addresses. We may review it from time to time to ensure the security of our website and prevent any harmful attacks.

12. Sending a message to our support system
When you send a message, we collect the data you have given to us in that message in order to obtain confirmation that you are entitled to receive the information and to provide to you the

information you need. We record your request and our reply in order to increase the efficiency of our business / organisation. We do not keep any personally identifiable information associated with your message, such as your name or email address.

13. Complaining
When we receive a complaint, we record all the information you have given to us. We use that information to resolve your complaint. If your complaint reasonably requires us to contact some other person, we may decide to give to that other person some of the information contained in your complaint. We do this as infrequently as possible, but it is a matter for our sole discretion as to whether we do give information, and if we do, what that information is.
We may also compile statistics showing information obtained from this source to assess the level of service we provide, but not in a way that could identify you or any other person.

14. Marketing information
With your permission we pass your email address and name to selected associates whom we consider may provide services or products you would find useful. You may opt out of this service at any time by instructing us at partnership@hostfamilies.co.nz

15. Re-marketing
We may use re-marketing from time to time. This involves Google or some other supplier placing a tag or marker on our website in order to be able to serve to you an advert for our products / services when you visit some other website.

16. Affiliate information
This is information given to us by you in your capacity as an affiliate of us or a customer or client of ours. Such information is retained for business use only. We undertake to preserve the confidentiality of the information and of the terms of our relationship. It is not used for any other purpose. We expect any affiliate to agree to reciprocate this policy. As an exception to this, we have the right to disclose your first name and URL of your affiliate connection to other affiliates and to any other person or organisation, on and off the website. The reason is solely to enable us to mention winners and others whose performance as an affiliate is in some way outstanding.

17. Use of the website by children
We do not market to children, nor do we sell products or services for purchase by children. We do sell products and services for end use by children, but for purchase by adults. If you are under 18, you may use our website only with consent from a parent or guardian.

18. Disclosure to Government and their agencies
We are subject to the law like everyone else. We may be required to give information to legal authorities if they so request or if they have the proper authorisation such as a search warrant or court order.

19. Compliance with the law
This privacy policy has been compiled so as to comply with the law of every jurisdiction in which we aim to do business. If you think it fails to satisfy the law of your country, we would like to hear from you, but ultimately it is your choice as to whether you wish to use our website.

20. Review or update personally identifiable information
At any time, you may review or update the personally identifiable information that we hold about you, by contacting us at the address below. To better safeguard your information, we will also take reasonable steps to verify your identity before granting access or making corrections to your information.

21. Removal of your information
If you wish us to remove personally identifiable information from our website, you may contact us at partnership@hostfamilies.co.nz. To better safeguard your information, we will also take reasonable steps to verify your identity before granting access or making corrections to your information.

22. Data may be “processed” outside New Zealand
Our website is hosted in New Zealand. We also use outsourced services in countries outside New Zealand from time to time in other aspects of our business. Accordingly, data obtained within the New Zealand may be “processed” outside New Zealand and data obtained in any other country may be processed within or outside that country.

Host Families NZ reserve the right to revise this privacy police at any time. If we do make any changes, we will post the updated privacy policy on our website.
If you have any question regarding the privacy policy, please contact us via email partnership@hostfamilies.co.nz or give us a call at +64 21 026 91882.

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Student/Intern Detail