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2024 7月 Study Tour Student Detail
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VISITOR DETAILS
Current School (請填中文 e.g.: 興大附中)
Your answer
Chinese Name
Your answer
English Name (Same as passport)
Your answer
Preferred English Name
Your answer
Gender
Male
Female
Clear selection
Birthday (DD/MM/YYYY)
Your answer
Address (in 中文)
Your answer
Email
Your answer
Current Year in School
Your answer
Number of years studying English
Your answer
Hobbies / Interests / Sports
Your answer
EMERGENCY CONTACT DETAILS OF PARENT/GUARDIAN
Full name
Your answer
Phone number
Your answer
Address
Your answer
Email
Your answer
MEDICAL DETAILS
Do you have any allergies
No
Yes
Clear selection
If yes, include any food, animal and drug allergies (please provide full details and medication taken)
Your answer
Do you have any illnesses/medical conditions?
No
Yes
Clear selection
Include asthma, diabetes, epilepsy or anaphylaxis (If yes, you must advise treatment and medication taken including use of an adrenaline autoinjector e.g. EpiPen)
Your answer
Is there anything else in the visitor’s history or circumstances not already advised that might pose a risk to students or staff in NSW government schools?
No
Yes
Clear selection
(If yes, you must provide full details):
Your answer
HOMESTAY
Smoking preference
Non-smoking
No preference
Outside only
Clear selection
Pets Preference
Prefer pets
No pets
Outside pets only
Clear selection
Children preference
under 10 years old
Above 11 years old
No children
Clear selection
Message to host family
Your answer
All of my family members (Name / Occupation / Age)
Your answer
Submit
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