| YOUR
GENERAL DETAILS |
| Your
Title |
|
Your
full name |
|
| Full
Address |
|
| County/State |
|
Post/Zip
Code |
|
| Country |
|
How
long have you lived at this address? |
|
| Daytime
Tel. |
|
Evening
Tel. |
|
| Fax
No. |
|
Email |
|
| Mother's
name |
|
Mother's
occupation |
|
| Father's
name |
|
Father's
occupation |
|
| 1st
Child's Name |
|
1st
Child's date of birth |
|
| 2nd
Child's Name |
|
2nd
Child's date of birth |
|
| 3rd
Child's Name |
|
3rd
Child's date of birth |
|
| 4th
Child's Name |
|
4th
Child's date of birth |
|
| Single
parent? |
Yes
No |
Nationality |
|
| Ethnic
Origin |
|
Religion |
|
| Family
Interests & Hobbies |
|
| YOUR
REQUIREMENTS |
|
Type
of au pair required?
|
Au Pair (up to 25 hours per week, incl. light housework duties)
Au Pair Plus (up to 35 hours per
week, incl. light housework duties)
|
| How
long do you wish to engage an applicant |
|
Ideal
Start Date (DD/MM/YY) |
|
| Age
Preferred |
|
Will
accept (male/female) |
|
| Will
accept an au pair from (enter country(ies) of origin) |
|
| Is
a car driver essential? |
Yes |
Nice to have |
No |
| Will
the au pair have the use of a car? |
Sole use |
By arrangement |
No |
| What
language level does the au pair need? |
|
| Please
give an indication of the timetable you expect the au-pair to work
(hours & tasks) |
| Monday |
|
Tuesday |
|
| Wednesday |
|
Thursday |
|
| Friday |
|
Saturday |
|
| Sunday |
|
Pocket
money per week |
|
| Supplementary
duties of the au-pair |
Cooking (for children only)
Washing
Vacuuming
|
Ironing
Dusting
Gardening
|
| Does
anyone in the family smoke? |
Yes
No |
If
yes, approximately how many per day? |
|
| May
the au-pair smoke? |
Yes
No |
|
|
| HOME
DETAILS |
| Is
your home in a... |
|
|
| No.
of bedrooms |
|
No.
of bathrooms |
|
| Will
the au pair have their own bedroom? |
Yes
No |
Other
facilities available for the au pair: |
|
| Do
you employ any other domestic help
(if yes, please give details) |
Yes
No |
Details:
|
| Do
you have any pets? |
Yes
No |
If
yes, please give details |
|
| Do
you have a garden? |
Yes
No |
How
far to the nearest shops? |
|
| How
far to the nearest bus stop? |
|
How
far to the nearest station? |
|
| How
far to the nearest Language college? |
|
Name
of college: |
|
| OTHER
ARRANGEMENTS |
|
Are
you prepared to contribute to the cost of a language course?
Yes (fully paid)
Yes (partly)
No
|
Will
you collect the au-pair from the station or airport?
Yes
No
|
|
Please
state your nearest station /airport
|
|
Where
did you hear about FrenchAuPairs.com? |
|
| Please
write a letter of introduction to the prospective au pair (to include
family background, hobbies, locality) |
|
| CHARACTER
REFERENCE |
| Please
enter the name and email address of a former au pair, or acquaintance,
whom can supply us with a character reference. |
|
Name:
|
|
Email
address |
|
| PREVIOUS
AU PAIRS |
| If
you have had au pairs before, it would help us greatly if you could
tell us some brief details (age, nationality, length of stay, your
learnings) so that we can get a better idea of your preferences
and requirements. |
|
|
