Accommodate Me

About you

Your name *

Nationality

Occupation

Name of spouse /partner

Nationality

Occupation

Hobbies & Interestes

Do either of you smoke? Yes No

Contact details

Address *

Town *

Poscode *

Email address

Home phone number

Mobile phone number

Work phone number

Energency number

Children

Child's name	Date of birth	Gender
		Male Female
		Male Female
		Male Female
		Male Female

Accommodation

Type of accommodation House Flat Maisonette

Type of board Half board B&B Self-catering

Gas saftey certificate Yes No

Smoke alarm Yes No

Available Rooms

Single rooms

Single rooms en-suite

Twin rooms

Double rooms

Pets & Facilities

Pets
Cat/s Dog/s Bird/s Other please specify

Access to
Television Video DVD Hi-fi Piano Internet Washing-machine Garden

Student Preferences (Please tick all that apply)

Age range up to 13 14 to 17 18 to 21 22 and over

Smoker Yes Maybe No

Male Yes Maybe No

Female Yes Maybe No

Couples Yes Maybe No

Meat eater Yes Maybe No

Vegetarian Yes Maybe No

Vegan Yes Maybe No

Halal / Kosher Yes Maybe No

Bank details

Account name

Account number

Sort code

Further Information

Further information

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the accommodation you can trust

I want to be a Host Family