Host Information First contact Name*: Email address*: Home phone number: Home address: Second contact Name: Email address: Home phone number: How many students could you accommodate?: Occupation: Is English the main language spoken in your home?: Please selectYesNo Have you ever hosted students before?: Please selectYesNo If yes, when was this?: If yes, please give information about the students: Please list any people living in the property and their ages, including children away at university, lodgers, etc.: Do you have any pets? Please provide details: Do you have a preference for student gender?: Please selectMaleFemaleNo preference Which age groups would you prefer?: Please selectUnder 1616-18 Do you offer Wi-Fi access?: Please selectYesNo Do you offer laundry facilities?: Please selectYesNo Catering Are you able to cater for special diets, e.g. vegetarian, kosher?: Are students allowed to use the kitchen, e.g. fridge/freezer, microwave, oven hob? Please selectYesNo Additional Information Student will be given information about your home when trying to find the most suitable match. Please give any extra information you would like potential students to receive, your hobbies or interest, special diets, work etc.: Referees Please provide the names and contact details for two referees, one ideally from a current employer. We will contact your referees following our home visit. Referee 1 Name: Email address: Telephone number: Referee 2 Name: Email address: Telephone number: DBS Check A DBS check will be required to access details of any spent and unspent convictions, cautions, reprimands, etc. from the Police national computer, information held by local forces, and lists of people barred from working with children and adults which are kept by the safeguarding Authority. A new DBS check must be carried out by us following a home visit and we are only able to accept a previous or current employers check if it is less than 3 months old. In order to complete a DBS check we will require the information below. If you wish this can be provided instead when we visit your home for an informal chat. Passport number: Passport expiry date: Driving license number: National Insurance number: By pressing apply, I confirm that the information given in this form is true and accurate.