Au Pairs
 
AU PAIR APPLICATION FORM

Fill out this online form, or else download the form from here

 
Please complete in the language of the country concerned and return by mail or submit on-line.

Date you are available (6 months minimum) :
From (Date) *: To (Date) *:
 
Family details
 
Name *:
Surname *:
Address:
Home number:
Mobile:
Fax:
Email Address *:
Age:
Place of Birth:
Date of Birth (dd, mm, year):
Nationality :
Father's Occupation:
Mother's Occupation:
Number and age of your brothers:
Number and age of your sisters:
Diet and particular food you don't want to eat (or allergies):
 
STUDIES
 
Have you attended school or university?
Yes No
If yes, please list the name and address of school or university attended:
Please describe studies or diplomas achieved:
Are you currently employed?
Yes No
If yes, please list the name and address of your employer:
Do you require English lessons?
Yes No
If no, how long have you been studying English?
Is your knowledge of the language
Excellent Good Fair
What is your first language ?
Do you speak additional languages ?
Yes No
If yes, please list the other languages you speak :
Have you taken any courses relating to child care?
Yes No
If yes, please give details :
 
Experience
   
Have you ever been "au pair" abroad?
Yes No
If yes, in which country?
What was the length of your stay:
 
Please estimate your skill level at the below tasks (tick where appropriate):
 
Task Skill level- Excellent Skill level- Good

Skill level- Fair
Cooking
Laundry
Ironing
Do you smoke?
Yes No
If yes, how many cigarettes per day?
Are you vegetarian?
Yes No
Are you physically fit?
Yes No
Is your health good?
Yes No
Do you have any psychiatric or disability problems?
Yes No
If yes, please give details of treatments you are receiving:
Do you like children?
Yes No
Have you already looked after any?
Yes No
Which age group do you prefer?
Baby between 0/8 months
 
Child under 4
 
Child between 4 to 8years old
 
Child over 8
Would you prefer to be placed in a family with:
1 child 2 children 3 children 4 children
Would you be willing to live with a family with a different religion or race?
Yes No
Do you like animals?
Yes No
Are you allergic to any animals?
Yes No
If yes, please give details :
Do you have a drivers licence?
Yes No
Would you prefer a family living in?
A town The country No preference
What are your favourite hobbies?
Please describe the reasons why you want to go abroad, giving as much information as possible about yourself:
 
 

 

Have you enclosed? (Please tick) :

    4 recent passport pictures
    2 pictures of you with children
    2 references (translated into English)
    Your criminal record
    Copy of your passport
    1 letter to the host family
    The character reference filled and signed*
    (* The reference letter must be handwritten by a person who has employed you in the domain of child care or house work. The contents of the document are imperative for a fast placement)
    125 of Registration fees*:
    (*Cashed only when the au pair finds her host family)
    150 Euro deposit*
    (*This cheque will be cashed only if the au pair hasn’t respected her engagement towards her host family or the agency)
*Field is mandatory
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