fbpx

    Please fill out the form below and submit to apply for an Au Pair position:

    Your First Name (required)

    Your Last Name (required)

    Preferred Country (required)

    Length of stay (months)
    61012

    Earliest date I can depart:

    Latest date I can depart:

    Latest date I have to return to my home country:

    Which area do you prefer?
    citysmall towncountry

    Your Email (required)

    Your Address (required)

    Address & Street:

    City, State, Zip, Country:

    Your Phone #'s

    Landline Phone #:

    Mobile Phone #:

    Your Skype ID

    Date and Place of Birth (required)

    Age

    Nationality (required)

    How many people in your family?

    Last diploma?

    Current Occupation?

    Do you smoke? (required)
    yesno

    If yes, how many cigarettes each day?

    If yes, would you refrain from smoking in the host family's home?
    yesno

    Do you have a driving license? (required)
    yesno

    If yes, since when?

    Driving experience
    goodsufficientpoornone

    Do you have any dietary restrictions? If yes, please explain:

    Do you have knowledge of first aid?
    yesno

    Do you have specific knowledge of childcare?
    yesno

    Can you swim?
    yesno

    What are your hobbies?

    Do you suffer from allergies?

    How would you rate your knowledge of the following languages:

    French:
    excellentgoodsufficientpoor

    English:
    excellentgoodsufficientpoor

    Other language:

    Rate knowledge of other:
    excellentgoodsufficientpoor

    Are you experienced in childcare of children in the following ages?
    baby9-12 months1-3 years3-6 years6-10 years

    Are you happy to care for any age?
    yesno

    If not, which age do you prefer?

    How long have you been taking care of children?

    Do you have experience with disabled children?
    yesno

    Are you willing to care for a disabled child?
    yesno

    Would you prefer to be in a home with 1, 2, 3 or 4 children?

    Are you willing to work with a single mother or single father?

    What experience do you have in domestic work? (please specify)

    Do you like animals?

    Would you look after animals?
    yesno

    Have you ever been an Au Pair before?
    yesno

    If so, in what country and for how long? Please specify place & date and provide references!

    REFERENCES

    Childcare Reference #1 name

    #1 email address

    #1 phone

    Job position

    Dates held

    Childcare Reference #2 name

    #2 email address

    #2 phone

    Job position

    Dates held

    Character Reference name

    CR email address

    CR phone

    CR Relation

    CR Since when