♥ Super Nanny Au Pair Services
♥ Waarom een Au Pair?
♥ Voorwaarden en richtlijnen Au Pairs
♥ Onze Au Pairs
♥ Au Pair Registration Form
♥ Information for Au Pairs
♥ Veel gestelde vragen
♥ Nieuwsbrief September 2018
♥ Intakegesprek familie
♥ Inschrijfformulier/Registration form Family
♥ Cultureel programma Au Pairs
♥ Reis boeken en verzekeringen
♥ Outbound Programma
Klik voor contact of bel +31 70 3814 812
+31 70 3814 812
♥ Au Pair Registration Form
Mobile phone number
Work phone number
Home mailing address
Date and place of birth*
Height/weight/hair color/eye color
Do you enjoy good health? If not please describe health problems
How many days have you missed work due to illness in the past 12 months?
Have you been treated for depression or mental illness in the past 12 months? If yes, please describe the situation and treatment
Have you ever suffered from an eating disorder such as anorexia of bolemia? If yes, please describe the situation and how long ago this was
Do you smoke? If yes, how many sigarettes per day
Would you refrain from smoking in the house, around the children and during working hours?
Do you have any allergies? If yes, specify
Do you have a special diet? If yes, specify
If yes, are you willing and able to prepare your own meals?
If yes, are you willing to prepare meals that you not eat for the family or children?
Do you have a driver's license? If yes, since when?
What kind of vehicle did you drive in the past 12 months?
How often did you drive a car in the past 12 months?
Can you drive a stick shift?
Can you drive an automatic?
Can you drive in the city?
Can you drive in the country side?
Would you accept a family with dogs, cats or other pets? If not, please explain
Do you know how to swim?
Do you know how to ride a bicycle?
Father's nationality and occupation
Mother's nationality and occupation
Ages of brothers and sisters, if any
Do you expect to attend religious services in Holland? If yes, please specify
Any dietary or other restrictions because of your religion. If yes, please specify
Country issuing your passport
Level of education reached + year of graduation
What other languages do you speak, and on what level? (fluent / good / basic)
Would you like to attend Dutch language classes?
Other work experience apart from child care/au pair experience (job description, yrs/mnths)
Do you have any criminal convictions?
Describe all your child care experience in as much detail as possible. (period, hours per week, ages of children, duties etc)
Did you take care of children independently
Are you prepared to take care of a baby (3 mnths - 1 yr old)? If not, please specify
Experience working with children 1 -3 years old?
Experience working with children 4 -7 years old?
Experience working with children 8 -12 years old?
Would you be willing to work with a disabled child? (autistic, physical disability, mental disability etc)
How many children would you like to work with?
Do you have any child care qualifications?
Have you ever done a first aid course?*
Do you know how to cook? If yes, what types of food do you usualy cook?
ARE YOU PREPARED TO DO LIGHT HOUSEWORK? Please keep in mind that some light housework is required!
Picking up after children
Shop for groceries
Are there any type of household chores that you do not wish to do?
PLEASE SELECT YOUR INTERESTS AND HOBBIES.
Like to read
Like to do arts and crafts with children
Like to sing or make music with children
Watch children's videos
Like to horse-play with children
What are your best personality traits?
What are your worst personality traits?
How would you describe your housekeeping style? (neat, more casual, messy etc.)
What type of working and personal relationship would you like to have with your host family?
What do you plan to do after completing your au pair assignment in Holland?
What do you like best about taking care of children?
What do you like least about taking care of children?
What are your favorite activities to do with children?
What do you consider to be appropriate discipline techniques for young children?
In your own words, explain your motivation to become an au pair and what you hope to find in a host family
Earliest possible date of departure (date)