Family form

We would like to have a au-pair *
- Female au-pair
- Male au-pair
FATHER / First name
Last name
Age
Profession
Nationality/Citizenship
MOTHER / First name
Last name
Age
Profession
Nationality/Citizenship
Phone
Fax
Phone at work
Address
City and Province
Zip code
Country
E-mail One valid e-mail address, thanks.
We live in
- House
- Apartment
Number of rooms
Will the au-pair have an own room
- Yes
- No
There (au-pair) are members in our family
- Yes
- No
We have (1,2, 3 or more) children
Age
Attends school/daycare
- Yes
- No
Age
Attends school/daycare
- Yes
- No
Age
Attends school/daycare
- Yes
- No
Does your family travel often
- Yes
- No
If Yes, will your au-pair travel with you
- Yes
- No
Are there smokers in your family
- Yes
- No
Does your family have pets, if yes what pets
Did your family have an au-pair before, if yes from what country
What year, how long time
How many days would your au-pair work during each week
How many hours would your au-pair work during each day
Please list the child care duties
Weekly pocket money and currency
Will you pay for any transfer trips that your au-pair has to make between your home and airport
- Yes
- No
If Yes, how could the transfer trip be arranged? Please name the nearest airport and/or station where you expect her to arrive. (Could you for instance drive the au-pair from there?)
We would prefer an au-pair who is, How old ?
We would prefer an au-pair who is able to speak English, German, Swedish or other language
The language we speak at home is
Will your au-pair be able to attend a language class at your expense
- Yes
- No
Will your au-pair need a driving licence and the ability to drive a car
- Yes
- No
Will your au-pair have access to a car
- Yes
- No
We need our au-pair for 6,8 or 12 months
Starting date, please
We would prefer to have an au-pair from
Give your future au-pair a short description of your family