Application
Form & Payment
CARRYCORD PTY. LIMITED
ABN 86 054 141 329
PO BOX 250, ST PAULS, N.S.W. 2031 AUSTRALIA
TELEPHONE (612) 9398 5103 MOBILE 0416 219 627 FAX (612) 89151741
Application
Form & Payment
Homeshare Includes meals Travellers must be 18 years and older
By the payment of this invoice, you have accepted our cancellation fees as stated on the application form and that you have read and accepted all information stated in our “Welcome to Australian Homestay” letter and you do not have any criminal convictions.
On receipt of completed Traveller Application and payment of our invoice, we will start to look for a homestay.
Please print your name here…………………………………………………………………....
Invoice 18 years and over
| Accommodation | A$250 per week |
| Arrangement | A$180 |
| Airport reception from airport | A$120 * |
| Administration fee | A$ 50 |
| Government Goods and Services Tax 10% | A$ 35 |
Please complete the number of weeks required
Accommodation ___ weeks x A$250 per week A$_________
Total invoice A$_________
Please TT to our account
with Westpac Bank 49-51 Belmore Road, Randwick, 2031
BSB No. 732-056
SWIFT # WPACAU2S Account Name is Carrycord Pty. Limited.
Account No. 66-1880
or Please charge the full amount to my Credit Card: Visa Mastercard
________ ________ ________ ________ Expiry Date___/___
The last three digits of the number on the back of the credit card___
Signature...................…….....Print Name..…………......................... Date......................
Please email or fax
signed invoice with Credit Card details or copy of funds TT.
Homeshare does NOT include meals.
On receipt of completed student application and payment of our invoice, we will start to look for a homeshare. Homeshare does NOT include meals.
By the payment of this invoice, you have accepted our cancellation fees as stated on the application form and that you have read and accepted all information stated in our “Welcome to Australian Homeshare” letter and you do not have any criminal convictions.
Please print your name here________________________________________
Invoice for Homeshare does
NOT include meals
| Accommodation for the first four weeks | $720 | ( $180/week ) |
| Accommodation arrangement fee | $180 | |
| Airport transfer fee | $120 | * |
| Administration fee | $ 50 | |
| Government Goods and Services Tax | $ 35 |
Please deposit to our account with Westpac Bank 49-51
Belmore Road, Randwick, 2031
BSB No. 732- 056 Swift # WPACAU2S
Account Name is Carrycord Pty. Limited.
Account No. 66-1880
or Please charge the full amount to my Credit Card: Visa______Mastercard______
Credit Card number______________________________________________________
Expiry Date_____/_____ The last three digits of the number on the back of the credit card___
Signature___________________Print Name__________________Date_____________
Did you hear about us from Council Exchanges? yes no
Your name Your address
Your email address
Your telephone No. Mobile telephone No. Fax No.
Nationality Passport Number Date of birth Male/Female
You require accommodation from / / to / /
Do you require airport
reception?
Flight details
.
Do you smoke?
Will you allow smoking in the house?
Do you have any illness or special dietary requirements?
Are you allergic to animals? What are your interests?
Other information:
Accommodation and Arrangement fees to be TT to our bank or Credit card and this form signed before arrangements can be made.
It is the travellers responsibility to ensure they possess proper and valid travel documents.
Cancellation fees:
Arrangement
and Airport reception fees are not refundable or transferable.
If the traveller cancels
prior to 30 days of booked date, full refund of accommodation less bank
charges.
If the traveller cancels
between 15 and 30 days of booked date, a fee equivalent to one weeks rent
will be charged.
If the traveller cancels
within 14 days of booked date, a fee equivalent to two weeks rent will
be charged.
If the traveller cancels
on or after the booked date, no refund will be given.
# Traveller or Agent must sign and date this Agreement that they have read and understood our cancellation fees and "Welcome to Australia Homestay" information and you do not have any criminal convictions.#
Signature...........................
Date..........................
