karen@aupairsnationwide.co.uk
01283 712188
Are you looking to become an Au Pair? Please fill in our online form.
Your Name (required)
Your Address (required)
Your County (required)
Your Daytime Phone Number (required)
Your Evening Phone Number (required)
Your Mobile Phone Number
Your Email (required)
Skype id
Date Of Birth:
Height:
Weight:
Religion:
Nationality:
Do You Have A Special Diet?:
Do You Have A Criminal Record?:
When Do You Want To Come To The Uk?:
Length Of Stay Required?:
Requested Return Date?:
Would You Prefer A Placement With A Family Living In: Town/CitySuburbsCountryDoes Not Matter
This is only a preference, it is not always possible to place everyone where they want to go.)
Do You Smoke?: YesNo
How Many?:
Do You Drive?: YesNo
How Long Have You Been Driving?:
Will You Accept A Placement With:
A Family With A Different Nationality/Religion: YesNo
A Single Parent: YesNo
Have You Looked After Children Before: YesNo
What Age Children Do You Prefer/Have Experience Of?: 0-18 Months18-24 Months2-4 Years4-8 Years8+ Years
How Many Children Do You Want To Look After?: 1- One2- Two3- Three4- FourDoes Not Matter
Have You Any Brothers Or Sisters?: YesNo
As An Au Pair You Will Be Asked/Expected To Help With The Running Of the Home. Are You Perpared To Help With:
Basic Cooking?: YesNo
Light House Work?: YesNo
Washing/Ironing?: YesNo
How Many Years Have You Studied English?:
How Good Is Your English?: FluentGoodReasonableFair
Do You Want To Go To Language School In The UK?: YesNo
Are You At University?: NoYes
Do You Plan To Go To University?: YesNo
What Are You Studying?:
What Are Your career Plans?:
What Is Your Father's Occupation?:
What Is Your Mother's Occupation?:
What Are Your Hobbies?:
Do You Like Animals?:
Do You Have Allergies?:
Have You Ever Been An Au Pair Before?: YesNo
If Yes, Give Details:
Name:
Address:
Tel Number:
Where Did You Hear About Richmond & Twickenham?:
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