Registration Form For Families Seeking Au Pair

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

Husband's Occupation:

Husband's Hours Of Work:

Husband's Nationality:

Husband's Religion:

Wife's Occupation:

Wife's Hours Of Work:

Wife's Nationality:

Wife's Religion:

How Many Children:

Names and Ages of Children:

Is A New Baby Expected?:

If Yes When?:

Type Of Home:

Reception: Bedrooms: Bathrooms: Toilets:

Other Rooms:


Family Pets:

Family Interests

Should the au pairs parents require a reference, please give name and address of someone who has known you personally for at least the last 2 years



How Did You Hear About Richmond & Twickenham?:

Location Details:

How Far Is the Nearest:

Public Transport:



English Classes:

Place Of Interest:

Au Pair Details:

Required Number Of Months:



Do You Need A Female Au Pair?:

Preferred Nationalities (Please leave blank if no preference):

Do You Need An Au Pair:

Car Driver:

Non Smoker:

Would You Accept A Smoker Who Is Happy To Smoke Outside?:

Other Preferences(if any):

Pocket Money To Be Paid:

Free Days:

Will The Au Pair Be Treated As A Member Of The Family, Joining You For Meals And Aslo The Evenings ETC?:

Treated As A Member Of The Family:

Au Pairs Accommodation:

Own television:



Please state how you would expect your au-pair to spend a typical day, remembering that she will not be expected to work for more than 6 hours a day and must be allowed time off during school hours to attend English classes.

Rise At:

Morning Duties:

Morning Duties 2:

Lunch At:

Afternoon Duties:

Afternoon Duties 2:

I have received, read and agree to your Accounts and Business terms.

I give consent for Au Pairs Nationwide (Richmond & Twickenham) to process, collect and store my data from this form in a secure and protected manner which is GDPR compliant. I understand that I have the right to withdraw it any time.

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