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Menu
What’s On
Annual Events
Autumn Colours Heritage Festival
Bathurst Heritage Week
Bathurst Rotary Gravel Cycling Festival
Bathurst Autumn Photo Competition
What’s On Mailing List
Add Your Event
Contact Us
In the News
What the Locals Love
Discover Bathurst
Destination Guide
Accessible Bathurst
Bathurst Sister Cities
Event Spaces
Live in Bathurst
Pet Friendly Bathurst
Sporting Facilities and Clubs
Where to Stay
Things to Do
Attractions & Tours
Taste Bathurst
Toast Bathurst
Explore the Villages
Get Outdoors
Arts and Culture
Discover Heritage
Go Shopping
Japanese Home Host Questionnaire
Thank you for expressing your interest in participating in the Japanese Home Stay Program. Please fill out the form below. The collection information provided by this form will be used only in the Japanese Home Hosting Program organised by the Bathurst Visitor Information Centre. For the purposes of allocating appropriate students to host families, and in creating host family profiles that will be provided to students to familiarise themselves with their host families.
Name
*
First
Last
Preferred Email Address
*
Primary Contact Number
*
Secondary Contact Number
Home Address
*
What is your date of Birth
*
In order to verify working with children certificates we require your date of birth.
Day
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Working With Children Identifier number
*
Please enter in the working with children identification number for each legal adult in your household (including spouses, children who are 18+ & relatives or visitors who will be living in your home during the student's stay). Please also include their birthday for verification purposes. It is a requirement of the homestay program that each adult 18+ living in the household possesses a working with children check, a volunteer check is acceptable. If you do not have a working with children number you can apply for a volunteer working with children check and provide the application number.
Do you have any pets?
No
Yes
If yes to the Question above. What animal/s and are they kept inside or outside?
This helps us align students with allergies to suitable host families.
How many students do you intend to host?
*
Please indicate how many students you would like to host.
1 Student
2 Students
3 Students
4 Students
Do you have a gender preference for the students you host?
No Preference
Male
Female
If your preffered student gender is not available, would you be happy to host students of the opposite gender?
No
Yes
Please Upload one photo of each bed you intend to provide to your student/s. If unable to upload your photos please email them to kyle.johnston@bathurst.nsw.gov.au
As a part of the Home Stay Program requirements. Students require their own bed in either a single or twin share bedroom (note that sharing with family members is not accepted). To ensure that we are sending students to homes that meet this requirement please upload a photo of each bed you intend to provide to your student/s. If you are unable to upload a photo/s please contact Kyle (kyle.johnston@bathurst.nsw.gov.au) at the Bathurst Visitor Information Centre to organise an alternative.
Drop files here or
Do you have children of your own? If so what are their names and age?
This helps us allocate students to families.
Does anyone in your household have first aid training?
This is not a requirement of the home hosting program but can assist is allocating students with medical conditions such as diabetes or severe allergies. Where in rare cases medical attention may be needed.
No
Yes
Are there any other comments or concerns that you wish to inform us of?