Get Au Pair Application Form

Au Pair Application Form Personal Details First Date Available Last Possible Starting Date Length Of Stay Long Term Medium Term Short Term First Name Surname Street Address Postcode Country Telephone number Day Skype ID Email Address Date Place of Birth Nationality Religion Do you regularly attend religious services Yes No Are you willing to work in a family that has animals Have you ever lived away from home for any length of time. i*e* 2months or more Please give details Details of parents/guardians/family Parents Address Parents Telephone Number Parents Fax Number Parents Email Address Fathers Occupation Family members brothers/sisters and ages Contact person in emergency Education and qualifications School attended examinations and qualifications Please give details Future educational plans Do you have knowledge of first aid or life saving Do you have any certificates Have you taken any courses related to child care Health Are you healthy If no please explain Are you allergic to animals Do you have any other serious allergies If yes please explain Do you have a special diet If yes please explain Smoking Do you smoke How many cigarettes a day If you do smoke are you willing to refrain from smoking in presence of children and in the host family house Driving Do you hold a current driving licence When did you receive the licence How much driving experience do you have Hobbies Interests What are your special interests/hobbies Do you participate in sports Do you swim Do you have a background in music or dance Employment record Past employment Present employment Length of notice required Experience with children Describe your experience of looking after children Have you experience with disabled children Have you been an au pair before If so in what country and for how long Preferences Which age group would you prefer to work with Newborns 9-12 months 1-3 years 3-6 years 6-10 years Older than 10 years Would you prefer to be placed with a family with 1 2 3 or 4 children small town village or in a rural area City Small Town Village Rural Area or father families of all ethnic and religious backgrounds If no please explain What experience of housework do you have Language Ability Languages spoken mother tongue first and second foreign languages English Verbal skills Poor Fair Good Fluent Number of years studied certificates held language instruction required Which educational courses do you wish to attend in your host country Reasons For Applying Why do you want to be an au pair Country preferred Region/Location preferred extra money PRINT NAME I confirm that the information i have supplied is correct DATE Please Note. once you have fully completed the form please save and email as an attachment along with any photographs to ruth aupairecosse. i*e* 2months or more Please give details Details of parents/guardians/family Parents Address Parents Telephone Number Parents Fax Number Parents Email Address Fathers Occupation Family members brothers/sisters and ages Contact person in emergency Education and qualifications School attended examinations and qualifications Please give details Future educational plans Do you have knowledge of first aid or life saving Do you have any certificates Have you taken any courses related to child care Health Are you healthy If no please explain Are you allergic to animals Do you have any other serious allergies If yes please explain Do you have a special diet If yes please explain Smoking Do you smoke How many cigarettes a day If you do smoke are you willing to refrain from smoking in presence of children and in the host family house Driving Do you hold a current driving licence When did you receive the licence How much driving experience do you have Hobbies Interests What are your special interests/hobbies Do you participate in sports Do you swim Do you have a background in music or dance Employment record Past employment Present employment Length of notice required Experience with children Describe your experience of looking after children Have you experience with disabled children Have you been an au pair before If so in what country and for how long Preferences Which age group would you prefer to work with Newborns 9-12 months 1-3 years 3-6 years 6-10 years Older than 10 years Would you prefer to be placed with a family with 1 2 3 or 4 children small town village or in a rural area City Small Town Village Rural Area or father families of all ethnic and religious backgrounds If no please explain What experience of housework do you have Language Ability Languages spoken mother tongue first and second foreign languages English Verbal skills Poor Fair Good Fluent Number of years studied certificates held language instruction required Which educational courses do you wish to attend in your host country Reasons For Applying Why do you want to be an au pair Country preferred Region/Location preferred extra money PRINT NAME I confirm that the information i have supplied is correct DATE Please Note. once you have fully completed the form please save and email as an attachment along with any photographs to ruth aupairecosse.