www.worldwideaupairs.com
 

Application for placement as Au Pair

» Please read our Au Pair Guidelines before completing this form

Please complete the application form below (your details will be treated in the strictest confidence)
About You
Full Name
Address
Telephone Number
E-mail
Date of Birth
Gender

Nationality
Passport No.
(if not in European Community)
 Nearest relative (person to contact in emergency)
Full name of relative
Contact telephone Number
Postal address
 Education and Experience
Do you have any qualifications (if yes then please give details if not then just enter 'no')
First aid knowledge (if yes then please give details if not then just enter 'none')
What is your present job? Please give dates (if none then enter 'none')
Previous jobs & dates
When can you start?
How long can you stay?
What is your ability level in English?
Other languages spoken
Do you wish to attend language classes?
 Childcare experience
Brief summary of your experience, indicating the type of care provided, ages of children and for how long you did this.
If you have been an au pair before, please give details, including which country and for how long

Training:

If you have had childcare training, then please give details
 Domestic Duties (tick all domestic duties you are willing to do)
Washing Up
Ironing
Cooking
Vacuuming
Dusting
Tidying
Driving
Do you hold a current driving licence?
When did you pass your test?
Are you willing to drive aboard?
If you have had any accidents then please give details
More about you
Do you have any brothers and sisters (if yes then please give ages)
Would you be prepared to work with disabled children?
Are you happy to live with pets?
What are your interests?
Why do you want to be an Au Pair?
Where would you be prepared to work (please tick all that apply) London Another city The countryside
Have you ever been abroad with your family (if yes then please give details if not then just enter 'no')
Have you applied for any courses or any other jobs (if yes then please give details if not then just enter 'no')
Have you ever been convicted of a criminal offence (if yes then please give details if not then just enter 'no')
Health Declaration
Are you undergoing any treatment, check up due to injury, handicap or physical disorder? (if yes then please give details if not then just enter 'no')
Do you suffer from any allergies? (if yes then please give details if not then just enter 'no')
Do you use any medication regularly? (if yes then please give details if not then just enter 'no')
Do you suffer from any kind of eating disorder? (if yes then please give details if not then just enter 'no')
Do you have any special dietary requirements, for example: are you vegetarian? (if yes then please give details if not then just enter 'no')
Height in metres
Weight in Kilograms
Do you smoke?
If you smoke, how many do you smoke per day?
Will you promise not to smoke in the house or in front of the children?
Where did you hear of IES Au Pairs?
 
Thank you for your completing this form

Remember:- You must also provide

I have read and understood the IES Au Pair Guidelines
 Yes
Click here to submit your application:
Click here to clear the form:
   
 
copyright © iesconsultants 2007