Expression of interest: Host family

Thank you for your interest in our host family program.

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* 1. Please complete the following details

Parent name 1

Parent name 2

Address

Suburb

Phone (M)

Email

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* 2. Number of children

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* 3. Number of children at home

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* 4. If you have children, what are their names and ages

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* 5. Do you have a current police check?

Yes

No (if you no, please note you will be required to undertake a police check)

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* 6. Briefly provide some background information about your family lifestyle

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* 7. What are your reasons for registering to become a host family?

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* 8. Please advise of any concerns you may have?