AUPAIR APPLICATION FORM
CHILD-(
3months to 2 years) (
3 to 5 years) (
FOR 1969 (REF NO: APF/ 015)
6 to 10 years) (
10 to 14 years)
Surname:
First Name:
Address:
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Phone Number:
Mobile Number:
Email:
Date of Birth:
Next of Kin:
Are you single:
Do you have children/ Child:
Do you smoke?
Do you swim?
Do you engage in any sports? Please specify:
Do you take any medication? Please specify:
Do you have special diet? (Vegetarian etc.):
Do you have any serious allergies? Please specify:
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Are you currently employed?
Do you speak/study any other language? What stage are you in the course ofstudy?
Do you have any knowledge of English?
What are your hobbies?
Do you have any experience with children?
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Have you ever been an au pair before? If yes, where and for how long?
Why would you like to be an au pair in the UK?
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(FOR NON BRITISH CITIZENS) Have you ever been in the UK before? If yes, give details of period and purpose ofvisit:
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I have gone through the details above and have provided the stated amount for the financial stability demonstration
(to be withdrawn back after verification process, or onarrival):
RIA Transfer
Money Gram
I attest that the above information is correct to the best of my knowledge.
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