Other Accommodation

About Agency

Agency email*

Partner/Agency*

Branch

Consultant Name

School student will attend classes*

Which Campus are you attending classes?

About Student

Student Full Name*

Student Email Address*

Cellphone Number*

Do you use WhatsApp on this line?*
YesNo

Do you use any other mobile apps? If so, please specify bellow. (number/App)

Date of Birth*

Gender*
MaleFemale
Emergency Contact: (Name/Phone Number)*

Home Address

Nationality*

First Language*

Check in date*

Check out date*

Do you have any health conditions that would interfere in the placement? (Example: diabetes,
high Blood
pressure...)
YesNo

If yes, please specify:

Do you take any regular medication?
YesNo

If yes, please specify:

Choose your City:

City*

If travelling with a second guest, please enter their full name below:

Choose your Accommodation option:

Choose your option:

Transfer Service

Would you like to request Transfer Service? (strongly recommended for minor students)*
Yes, Pick-up onlyYes, Pick-up and Drop-offNo, I don't need transfer service

Flight Information

Do you have your Flight information? (If yes, please fill out the information bellow)*
YesNo

Airline and Flight Number:*

Arrival Date and Time:*