AuPair Applicatio Form :::

	Home

	About Us

	Services

	Contact Us

Family Requirement Form (Free Registration)

We welcome families to register by filling our family requirement form so that we can be well acquainted to their needs and hence we will be able to match them with the right candidate. Please note that registration is free

Last Name:

First Name(s):

Marital Status:

Are You A Single Parent:

Please Give Detail:

Address:

Address2:

City:

Post Code:

Country:

Telephone:

Mobile:

Fax Number:

E-mail Address:

Family details

Do Both Parents Work:

Father's Occupation:

Mother's Occupation:

Does father Smoke:

Does Mother Smoke:

Does Anyone Else In The Family Smoke:

No of Children

1st Child:

Age:
Sex:
School Hours:	(hh:mm to hh:mm)

2nd Child:

Age:
Sex:
School Hours:	(hh:mm to hh:mm)

3rd Child:

Age:
Sex:
School Hours:	(hh:mm to hh:mm)

4th Child:

Age:
Sex:
School Hours:	(hh:mm to hh:mm)

Type of Accommodation:

Would Au Pair Have His/Her Own Room:

Closest Airport:

Closest Underground/Train Station:

Do you have pets:

Family's Special Interest And Hobies:

Preferences In Au-Pair

Type of Au Pair required:

Driving Requirement:

Would You Accept A Temporary Au Pair:

Please Give Expected Au Pair Time Table:

Salary Per Week:

Duties of The Au-pair/AuPair+:

Length of Stay:

Preffered Nationality:

Age Preffered:

Do You Mind Smoking Au Pair:

Would You Help With Course Fee?:

Would You Pick Up Aupair At Airport:

Date requied to start:

(dd:mm:yyyy)

Do You Agree To Charges and Terms & Consitions: