Sydney Student Accommodation Request - Lenards Homestay Agency

ACCOMMODATION REQUEST
NAME
E-MAIL
POSTAL ADDRESS
AGE		SEX	Male Female
NATIONALITY
OCCUPATION
TELEPHONE	Please include country code and area code
FAX	Please include country code and area code
LENGTH OF STAY
ARRIVAL DATE	dd/mm/yy	DEPARTURE DATE	dd/mm/yy
FLIGHT NO.		AIRLINE
AIRPORT PICK-UP	Yes No
ACCOMMODATION REQUIRED
REQUIREMENTS	Twin Single Other	B&B All Meals Room Only	Ensuite Private Bath Shared Bath
OTHER REQUIREMENTS
PREFERENCES
FAMILY WITH CHILDREN	Yes No Either	FAMILY WITH PETS	Yes No
SMOKER	Yes No	SMOKERS IN HOUSEHOLD IS OK?	Yes No

PREFERRED LOCATION
PARKING	Is a car parking space required at the host family residence?	YesNo
FOOD PREFERENCES	Do you have any special food requirements or restrictions?	Yes No
	Details
MEDICAL	Do you have any allergies or special medical needs?	YesNo
	Details
COMMENTS & SPECIAL REQUESTS	Please use the space below for any extra comments or special requests you may have
HOW DID YOU HEAR ABOUT LENARDS?
NB: All Information submitted is strictly confidential and will be used solely for the purpose of providing you with the best possible accommodation to suit your needs. Please make sure all details are correct before submitting, thank you
. Please note that a non-refundable deposit is required before we can finalise and secure your booking For Payment methods etc see Contact Details