T.
+44 (0) 1225 423327
M.
+44 (0) 7715 123299
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mail@crownguardians.co.uk
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Host Family Claim Form
Host Family Claim Form
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Host Family Details
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Full Name
Email
Telephone
Payment Per Night
Address
City
Postcode
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Student 1 Details
Full Name
School
Date from (dd/mm/yy)
Date to (dd/mm/yy)
Number of Nights stay
Travelling Expenses
(miles to and from school / trips)
Travelling from
Date of travel
Travelling to
Miles
Travelling Expenses 2
Travelling from
Date of travel
Travelling to
Miles
Additional Expenses
(eg. telephone, entertainment, pocket money, etc)
Additional Expenses 1
Details of expenses
Date
Total cost
Additional Expenses 2
Details of expenses
Date
Total cost
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Student 2 Details
Full Name
School
Date from (dd/mm/yy)
Date to (dd/mm/yy)
Number of Nights stay
Travelling Expenses
(miles to and from school / trips)
Travelling from
Date of travel
Travelling to
Miles
Travelling Expenses 2
Travelling from
Date of travel
Travelling to
Miles
Additional Expenses
(eg. telephone, entertainment, pocket money, etc)
Additional Expenses 1
Details of expenses
Date
Total cost
Additional Expenses 2
Details of expenses
Date
Total cost
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Next
Student 3 Details
Full Name
School
Date from (dd/mm/yy)
Date to (dd/mm/yy)
Number of Nights stay
Travelling Expenses
(miles to and from school / trips)
Travelling from
Date of travel
Travelling to
Miles
Travelling Expenses 2
Travelling from
Date of travel
Travelling to
Miles
Additional Expenses
(eg. telephone, entertainment, pocket money, etc)
Additional Expenses 1
Details of expenses
Date
Total cost
Additional Expenses 2
Details of expenses
Date
Total cost
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Summary of Totals Payable
Homestay
Total No. of Nights:
0
Total Amount £
0
Travel
(£0.50 per mile)
Total Miles:
0
Total Amount £
0
Additional Expenses
Total Additional Expenses Amount £
0
Grand Total Payable (£'s): £
0
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Bank Payment Details
Details required only for first time payments or if your account details are different to those we already hold.
BACS Details
Bank Name
Account Name
Sort Code
Account Number
Cheque Details
If payment by cheque is prefered
Name on Cheque
Please note: BACS payment is preferred as payments are transferred directly into your bank account and waiting time for postage, paying in the bank and waiting time to be cashed is avoided. We aim to complete payments within 24 - 48 hours after receipt of the completed claim form.
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If you require any information about how we can help you, please contact us.
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