Hosting Application
Please provide the following contact information:
(This information will be kept confidential)
Please note this form will open your default Email handler to perform the submission - this is normal

Full Name (Real)

Name (Nick)

Work Phone

Home Phone

E-mail

Your Homepage URL 


Your Age Group:

Your Gender:


Which state do you live in (Australia) or Country Outside of Australia:

In Australia -     

or  Outside Australia  -   


Have you had any previous hosting experience?Yes


Which room is your first choice for hosting in:
If not your previous choice, what other room:
Tell us why you think you would make a good host:

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