Registration Form for Students Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *FirstLastNationality *Gender *MaleFemaleOtherPrefer not to sayAge *Phone Number *Email *Date of Birth (DD/MM/YYYY) *Special Diet/Allergies *Are you a smoker?YesNoHome AddressEmergency ContactEmergency Contact NumberPassport NumberWhich package would you like to avail of?Academic Program Full term (9 Month) or Half term (4 Months)Work Experience and English Immersion PackageSports-Specific Immersion PackageHow did you hear about APS Homestay?Arrival Date (DD/MM/YYYY)Departure Date (DD/MM/YYYY) Preferred LocationTravel card required?YesNoDo you require airport transportation?From the airportTo the airportBothIs it suitable for pets to be in the house?YesNoI have insurance?YesNoAdditional CommentsI agree to have my information stored by APS HomestayYesSubmit
