Name

Address

Telephone

Mobile Phone

email

Father's Profession

Mother's Profession

Marital status

Children's name, age and gender

Is a baby expected?

What is your passport nationality?

Do any of the children have special needs?

Do any other person's live in your household?

Any other languages spoken at home?

What date is the au pair ideally required?

Is a driving licence required?

Is a car available off duty?

What are the principle duties you wish

the au pair to cover?

Do have any pets?

Will the au pair be left in sole charge

of children?

What social, recreational or church

activities are available?

Please write a description of your home.

Please write a description of

the au pair's room.

Are you practising Christians?

What is your regular place of worship?

How regular do you attend?

Would you describe your own church

and any other options.

Would you consider a male au pair?

How many hours per week do you require?

Where did you hear about us?

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