Au-Pair Application Form

Contact Details Family Name & Address
Telephone Number (home) (mobile)
E-mail

Family Background Name of Father Age
Occupation Nationality
Name of Mother Age
Occupation Nationality
Marital Status Name of Child
Age School
Name of Child Age
School Name of Child
Age School
Name of Child Age
School
Any extra information about children
Native Language spoken in the family Other languages spoken
Religion Practicing? Yes No
Pets? Yes No Type Family interests
Is your family vegetarian? Yes No Have you employed au-pairs before? Yes No
Which Nationalities

Au-Pair Profile Preferable Age Gender Male Female
Level of Education Required knowledge of English
Driving Licence Yes No Automatic Manual Would you accept a smoker? Yes No Required childcare experience
Required experience with babies
Do you have any special wishes concerning the Au-Pair?

Au-Pair Duties and Conditions Commencement date Length of employment
Please describe the childcare responsibility
Please describe the housekeeping responsibility
Does the family employ any other domestic help? Yes No
Days off Babysitting Pocket money offered weekly
Please describe the accommodation offered to the Au-Pair

General Information
Please describe your home and the location
What facilities are available in your suburb/town?
Who recommended our agency?
Will you go to the airport/station to collect your Au-Pair or would you pay for a taxi?

Submission of this form will enable us to understand your exact requirements. A hard copy together with our terms will be sent to you for agreement and signature