*
For (amount of months)
Other countries of specific areas of interest
Would you accept a family who lives in the countryside?
Would you like to start as soon as possible?
If no, when would you like to start?
First and middle Name(s) *
Last name *
Sex
Age: *
Date of birth *
Cellphone or phone *
WhatsApp
Current address *
Current city *
Current zip/postal code *
Current country *
Nationality / citizenship *
E-mail *
One valid e-mail address and nothing else, thanks!
Your current marital status *
Do you have any brothers or sisters?
If Yes, how many and what are their ages?
Have you worked with children before?
If Yes, PLEASE indicate age!
Are you a good driver with a driving licence?
Do you have a criminal record?
Do you smoke?

Education

Level Of Education

Elementary school:

From
To

High school:

From
To

College:

From
To
Other information about education: 

Profession (name the last three employments):

Employment 1
From
To
Employment 2
From
To
Employment 3
From
To
Have you worked as an au pair in europe before?
If Yes, tell us what country and what year?:
Have you worked as a domestic helper before?
If Yes, tell us what country and what year?:
Other information
Do you have any references from those families?

If Yes, please add name and phone numbers:

Name
Phone
Name
Phone

Please add another contact person that knows you:

Name
Phone
Your personality and why you wish to be an au pair.
(English please and not more than 250 characters)
Are you allergic against something?
If Yes, what?
What child diseases have you had?
Have you had any serious sickness or handicap lately?
If Yes, what?
Can you send us a medical certificate if required?
What languages do you speak and at what level?
(1 = Mother tongue  2 = Advanced  3 = Intermediate  4 = Basic)
I would be interested in a language class to improve my
Can you swim?
Are you a vegetarian (not eating meat, fish and poultry)?
Do you like pets?
Write a short "Dear family"-letter to your future host family where you tell something about your hobbies, personal interests and future plans
English please and not more than 250 characters
The best time to reach me is
Do you have a contact or an agency that will help you deal with our enquiries?
If Yes, please specify contact or agency (including phone number):
Do you want us to present an advertisement on our web site? The ad will be anonymous. It will show the photo you upload below, your first name, the country you would like to work in, your country of residence, your age, and the information you gave about driving licence, previous child care experience, and personality. The ad will increase your chances of getting the perfect host family fast.
Warning: If you select "No" your ad will be invisible!
We recommend that you upload a good photo of yourself. The photo will appear in the advertisement mentioned above


VERY IMPORTANT INFORMATION! READ CAREFULLY!

Click only once on the Submit button below. Then send us, as soon as possible, the following items by e-mail or regular mail:

1. More photos. We will gladly receive them by e-mail, but please make sure the photos are JPG files and not bigger than 1 MB.

2. If possible, you should also send us some references from a family you have been working for, or someone who can confirm that you have been working with children before.

We will not handle applications without photos!