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Last Name
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First Name(s)
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Gender
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Date of Birth
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Place of Birth
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Nationality
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Religion
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Full Address in your home Country
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Post Code
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Contact Address (if different)
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Post Code (Contact Address)
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Telephone Number (Home)
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Mobile Number
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Fax number
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E-mail
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Passport Number
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Expiry Date
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What is the shortest period you are willing to stay?
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Earliest Start Date
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What is the longest period you are willing to stay?
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Latest Return Date
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Father`s Name and Occupation
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Mother`s Name and Occupation
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Name and Age of Brother(s) and Sister(s)
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Which countries would you wish to go to as an Aupair?
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What is your level of speaking English ?
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Fluent
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Intermediate
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Basic
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What is your level of reading English ?
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Fluent
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Intermediate
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Basic
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Would you like to attend a language course whilst in your host country?
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Yes
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No
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Please list any other languages you can speak and how fluently.
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Have you ever been an Au pair before, or lived away from home ?
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Yes
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No
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If Yes, please give details.
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Please describe your level of education and any qualifications you have.
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Please describe any childcare experience you have had.
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How many hours per week would you like to work ?
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25
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35
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Which ages of children would you like to look after ?
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0 - 2 years
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3 - 4 years
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5 - 8 years
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9 - 12 years
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13 + years
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How many children would you prefer to look after ?
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1
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2
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3
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4
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Any Number
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Would you be willing to care for a child with a disability or learning difficulty ?
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Yes
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No
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If Yes, please provide details of any experience you have.
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Would you be willing to care for the elderly?
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Yes
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No
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Where would you like to work ?
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City
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Town
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Village
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Coast
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Countryside
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Anywhere
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Do you smoke ?
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Yes
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No
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If Yes, would you agree not to smoke -
in the house ?
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Yes
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No
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where there are children ?
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Yes
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No
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Would you accept a family who would smoke ?
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Yes
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No
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Do you hold a full driving licence ?
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Yes
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No
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Would you want to drive in the UK ?
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Yes
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No
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Do you have any criminal convictions ?
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Yes
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No
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If Yes, please provide details.
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Are you vegetarian ?
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Yes
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No
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Would you accept a single parent family?
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Yes
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No
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Would you be willing to care for pets?
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Yes
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No
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What height are you ?
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What weight are you ?
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How did you hear about Aupair2u ?
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Please provide details of any allergies or medical conditions the family should know about.
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If you are currently at school or university, when do you finish ?
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Where have you worked since leaving school or university ?
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What plans do you have for your future career ?
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What are your interests and hobbies ?
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Can you swim ?
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Yes
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No
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Do you have a certificate in first aid ?
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Yes
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No
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Which household tasks are you used to doing regularly ?
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Cooking
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Ironing
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Cleaning
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Shopping
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Please now give any other details we should know before we search for a host family for you.
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Please provide a Dear family letter , introducing yourself to the host family.
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Declaration ----- I AGREE ( YES or NO )
I confirm I have answered all the questions above honestly and all of the information on this application form is correct and true to the best of my knowledge. I give permission for Aupair2u to hold and process my personal information supplied on my application and my other documents. I understand this may be passed on to families.
If I decide to cancel this application, I will notify the agency immediately. I will also inform the agency if there are any changes to the information provided.
I understand the placement may be terminated if I do not follow the agency guidelines, provide any false information with my application, or disobey the laws in the host country.
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