Family Application Form

Please fill in the following Application Form

Family Details

Full Name:

Title:

Nationality:

Occupation:

Age:

Marital Status:

Partner's Name:

Nationality:

Occupation:

Age:

Address:

Email Address:

Postcode:

Tel (Home):

Tel (work/mob):

Do you have Skype:

Children's Details

Please give full details about your children:

Name:

DOB:

Sex:

Name:

DOB:

Sex:

Name:

DOB:

Sex:

Name:

DOB:

Sex:

Name:

DOB:

Sex:

Name:

DOB:

Sex:

Is there any other person permanently resident in your household?

If yes, please give further details:

Name:

Age:

Relation to family:

Is a new baby expected

Is any member of your family disabled? If yes, please specify:

Family's Details

Is your family vegetarian?:

Do you have any pets?:

If yes, please specify:

What are your family interests and hobbies?:

What is your family Religion?:

Practising:

Does anybody in your family smoke at home?:

What is the main language spoken in your home?:

Family Home Details

Type of home(house/ flat/farm:)

Do you live in:

Any other relevant features of your home?:

Number of Bedrooms?:

Number of Bathrooms?:

Do you have a garden?:

Au-Pair Requirements

Au-pair Requirements:

Au-pair position available from:

Length of Au-pair stay:

Au-pair Nationality:

Would you prefer:

How much knowledge of English would you prefer:

Do you need an Au-pair who can drive?:

Any other skills required (e.g. swimming):

Would you accept a smoker?:

Au-Pair in your Family

Will your Au-pair have his/her own room?:

Please specify what your Au-pair's room will contain (e.g. TV, dressing table, own bathroom etc):

What will be your Au-pairs's duties?
Childcare: School: Hoovering: Dusting: Ironing: Washing: Cooking:

Please give a sample Time Schedule:

How many hours per week will you require from your Au-pair?:

Your Au-pair's days off:

What will be your Au-pair's pocket money?: /weekly

Payable on what day of the week?:

Will you pay for the extra travel costs if your Au-pair need to get to the language school from rural area?:

I agree for the Au-pair to attend language classes:

Further Information

Details of previous Au-pairs/Nannies:

Do you employ any other household help?:

If yes, give further details:

Please give any other additional information which can help us find the most suitable Au-pair for your family:

Our families are usually able to meet and collect the Au-pair on his/her arrival. If this would be inconvenient for you, would you reimburse your Au-pair's travel cost from the point of UK arrival to your home?

Our Agency uses a database of current families to provide Au-pairs with contact telephone numbers of fellow Au-pairs in the locality to help them find friends. Can we also include your home telephone number?:

Where did you hear about Sunny Smiles Au-pair Agency?

Please select which payment option you prefer (for full explanation of click here)
All information given above is correct, and I agree to the Terms & Conditions (click to read)

Date: dd/mm/yyyy