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 of study?
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 of visit:
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