Please fill out the form below to be considered as a sharer in our Homeshare program.
Please read the Sharer Terms & Conditions before submitting the form.
Date of Application*
Date of Birth
Place of Study or Work
Details of Study or Work (days and hours)
How did you hear about Holdsworth HomeShare? Click on the box to select an option.
—Please choose an option—Word of mouthSocial mediaAdvertisementWebsiteEventOther
Why do you want to become involved in Holdsworth HomeShare? Click on the box to select an option.
—Please choose an option—AffordabilityCompanionshipSafetyProximity to work/studyOther
Are you prepared to undergo a Police Check?
How long do you want or need accommodation for? Minimum 12months required**
Read and agreed to the Terms and Conditions.
I confirm that the information given in this form is true, complete and accurate.
I confirm that I will notify Holdsworth if there is any change of circumstances.
** Please note the answers to these questions for grant reporting purposes.
How many years have you known them for?