Last name (*)
First name(s) (*)
Gender
Female Male
Date of Birth (*)
Place of birth
Nationality (*)
Religion
Full Address in your home Country
Postcode / Zipcode
Contact Address (if different)
Post Code (Contact Address)
Telephone Number (Home)
Mobile Number
Email (*)
Passport Number
Expiry Date
What is the shortest period you are willing to stay?
Earliest Start Date
What is the longest period you are willing to stay?
Latest Return Date
Father`s Name and Occupation
Mother`s Name and Occupation
Name and Age of Brother(s) and Sister(s)
Which countries would you wish to go to as an Aupair?
What is your level of speaking English ? (*)
Fluent Intermediate Basic
What is your level of reading English ? (*)
Fluent Intermediate Basic
Would you like to attend a language course whilst in your host country?
Yes No
Please list any other languages you can speak and how
Have you ever been an Au pair before, or lived away from home ?
No Yes
If Yes, please give details.
Please describe your level of education and any qualifications
Please describe any childcare experience you have had.
How many hours per week would you like to work ?
25 35 Any Number
Which ages of children would you like to look after ?
Age 0 - 2
Yes No
Age 3 to 4
Yes No
Age 5 to 8
Yes No
Age 9 to 12
Yes No
Age 13 +
Yes No
How many children would you prefer to look after ?
1 2 3 4 Any Number
Would you be willing to care for a child with a disability or learning difficulty ?
Yes No
If Yes, please provide details of any experience you have.
Would you be willing to care for the elderly?
Yes No
Where would you like to work ?
Anywhere City Countryside
Do you smoke ?
No Yes
If Yes, would you agree not to smoke in the house ?
Yes No
Would you accept a family who would smoke ?
Yes No
Do you hold a full driving licence ?
No Yes
If Yes, which country was it issued in
Would you be willing to drive in host country?
No Yes
Do you have any criminal convictions ?
No Yes
If Yes, please provide details.
Are you vegetarian ?
No Yes
Would you accept a single parent family?
Yes No
Would you be willing to care for pets?
Yes No
What height are you ?height are you ?
What weight are you?
Please provide details of any allergies or medical conditions
If you are currently at school or university, when do you finish ?
Where have you worked since leaving school or university ?
What plans do you have for your future career ?
What are your interests and hobbies ?
Can you swim ?
No Yes
Do you have a certificate in first aid ?
No Yes
Which household tasks are you used to doing regularly ?
Cooking
No Yes
Ironing
No Yes
Cleaning
No Yes
Shopping
No Yes
Please now give any other details we should know before we search for a host family for you.
Please provide a Dear family letter , introducing yourself to the host family.
Where did you find out about Aupair2u ?
DECLARATION ---:
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.
I AGREE (Yes / No) (*)
Yes
No
