Host Family
Application

Personal Information Personal Information * Priceless Exchange is committed to handling your personal information in accordance with the Privacy Amendment (Private Sector) Act 2017. Any personal information collected in this application will be used by Priceless Exchange staff and/or chosen representatives to assist us in our service

Damage and Liability Damage and Liability * Demi Pair' s are covered under our Damage and Liability Insurance, as well as travel and medical insurance. We encourage families to check Public Liability and car insurance to ensure the Demi Pair is covered in the case of an accident.

Screened Screened * Demi Pair Students are all screened and interviewed with a minimum of pre-intermediate level of English. Demi Pairs have some experience with housework and childcare (as outlined in their profile) and are generally placed in a Mothers Helper position. A Demi Pair exchanges 15 hours of help with housework and childcare for a room and meals.

Treatment Treatment * We ask that you treat your Demi Pair as part of your family and oversee their welfare during their stay. We ask that you report any unusual behaviour to our team immediately.

First Name *

Last Name *

Email Address *

Phone Number *

City * City * *SydneyGold CoastBrisbaneSunshine CoastCairnsMelbourneAdelaidePerthQLD - OtherNSW - OtherVIC - OtherOther/Overseas

Occupation *

Partners Name

Partners Occupation

Address *

Does your home have access to public transport? * Does your home have access to public transport? * Host Families need to live within walking distance to a bus stop, as Demi Pairs need to be able to be independent. Yes No

Are all members of your Family 16 years or older fully vaccinated against Covid-19? * Are all members of your Family 16 years or older fully vaccinated against Covid-19? * Yes No Prefer not to say

1st Child Name *

1st Child Birth Year * 1st Child Birth Year * *202420232022202020192021201720182016201520142013201220112010200920082007

2nd Child Name

2nd Child Birth Year 2nd Child Birth Year202420232022202120202019201820172016201520142013201220112010200920082007

3rd Child Name

3rd Child Birth Year 3rd Child Birth Year202420232022202120202019201820162017201520142013201220112010200920082007

4th Child Name

4th Child Birth Year 4th Child Birth Year202420232022202120202019201820172015201420132016201220112010200920082007

If more than 4 children, please list them here

What are your family's interests and hobbies? *

Is your family bi-lingual? * Is your family bi-lingual? * Yes No

If YES, do you manly speak English at home? If YES, do you manly speak English at home? Yes No

Does any household member have any medical condition or special needs that affect the Demi Pair? * Does any household member have any medical condition or special needs that affect the Demi Pair? * Yes No

If YES, please provide details

Does your family have any special dietary requirements? * Does your family have any special dietary requirements? * Yes No

If YES, please provide details

Do you have pets? * Do you have pets? * Yes No

If YES, please provide details (include if indoors and/or outdoors)

Do you have other help at home? * Do you have other help at home? * No Regular cleaner Occasional cleaner Occasional evening babysitter AuPair/Nanny Grandparents/Family Gardener

Describe your Demi Pairs room * Describe your Demi Pairs room * Bed Bedside table Storage Desk Private bathroom Shared bathroom Limited WIFI Unlimited WIFI No WIFI

Describe the days and hours you would like your Demi Pair help you? * (Please keep in mind that most Demi Pairs attend Language School daily between approx 8.30-9am to 1-3pm)

Describe the help you need. Please keep a nice balance between housework and childcare *

Can you provide a fair and suitable work schedule and be flexible if needed? * Can you provide a fair and suitable work schedule and be flexible if needed? * Yes No

Are you willing to provide training in the first week and work through any issues if needed? * Are you willing to provide training in the first week and work through any issues if needed? * Yes No

Would your Demi-Pair be allowed to smoke? * Would your Demi-Pair be allowed to smoke? * No Yes, outside only Social smoking away from home

Do you need your Demi-Pair to drive a car? * Do you need your Demi-Pair to drive a car? * Yes No Preferred but not necessary

Would you consider a male Demi-Pair? * Would you consider a male Demi-Pair? * Yes No Maybe

Do you require your Demi Pair to swim? * Do you require your Demi Pair to swim? * Yes No

Host Family understands Host Family understands * As a Host Family we understand that the Demi Pair helps 15 hours per week with childcare and housework. Housework and childcare should be well balanced. In exchange, a Host Family provides a private room, breakfast and dinner Monday to Friday plus 3 meals per day on weekends, and an English speaking environment.

Training Provided Training Provided * As a Host Family we understand that it is our responsibility to train our Demi Pair and help to understand the provided Working Schedule. We understand that we have to keep the jobs to the ones outlined in the Family Profile Form. We understand that it is our responsibility to provide our Demi Pair with adequate information about our family’s standards and expectations to help our Demi Pair settle in easily and quickly.

Contact Priceless Exchange Contact Priceless Exchange * As a Host Family we understand that we need to contact Priceless Exchange immediately, should we experience any challenges with our Demi Pair. We agree to try our best always to work through any challenges.

Commitment Commitment * As a Host family we understand that we commit to a 12 week placement. Asking our Demi pair to leave within that time frame can result in a commitment of paying for accommodation and meals for our Demi Pair, UNLESS arranged otherwise with Priceless Exchange.

Program Parts Program Parts * As a Host Family we understand that the Demi Pair program consists of 2 parts; the 15 hours help provided from our Demi Pair, plus social time spent with the Demi Pair. The 15 hours are considered the working hours and are paid equivalent to the Australian minimum wage in form for a private room and meals. As a Host Family we can expect our Demi Pair to honour this time to the full potential. We agree to spend social time with our Demi Pair as well, inviting her/him to some of our weekend outings ect.