Host family
requirements
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Dossier
Status |
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Family
Last Name* |
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Email
Address - Main contact* |
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First
Name of whoever is completing the form* |
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Mobile
- Main contact |
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Your requirements
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Preferred
start date |
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Latest
possible start Date |
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Preferred
finish date |
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? |
Male
or Female Au Pair ? |
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Minimum
Age |
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? |
Driver
absolutely essential? |
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? |
How
will you help your Au Pair adjust to driving? |
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Minimum
English level |
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Speak
French to kids? |
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? |
Accept
smoker? |
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? |
Type
of personality/interests would suit kids? |
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Best
fit for our family and lifestyle |
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About the position
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Maximum
number of hours on duty per week |
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Hours and pocket money guidelines |
Number
of hours housework per week |
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Description
of the position (timetable, duties) |
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Tasks
you may need your Au Pair to do |
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Check the recommended tasks here |
Weekly
pocket money |
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? |
Monthly
contribution to English lessons |
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? |
Placement
completion bonus (amount and date due) |
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Which
2 full days will they be free? |
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? |
Do
you offer any of these optional benefits? |
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? |
More
details regarding the benefits offered |
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When
our family goes away on holiday we will |
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Who
covers the childcare when Au Pair is off/away |
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About your children
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How
many children do you have? |
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Are
all children permanent residents in the home? |
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1st
child - Name |
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1st
child - gender |
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1st
child date of birth |
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1st
child personality / interests |
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1st
child special needs |
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2nd
child - Name |
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2nd
child - gender |
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2nd
child date of birth |
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2nd
child personality / interests |
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2nd
child special needs |
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3rd
child - Name |
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3rd
child - gender |
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3rd
child date of birth |
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3rd
child personality / interests |
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3rd
child special needs |
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4th
child - Name |
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4th
child - gender |
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4th
child date of birth |
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4th
child personality / interests |
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4th
child special needs |
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Any
further children |
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Is
there a baby due? What's the due date? |
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About the adults
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First
name (Mother/Live in partner) |
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Nationality
(Mother/Live in partner) |
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Profession
(Mother/partner) |
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Approx
how many hours worked/week (Mother/partner) |
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Age
(Mother/Live in partner) |
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Level
of French (Mother/Live in partner) |
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Other
languages (Mother/Live in partner) |
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First
name (Father/Live in partner) |
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Nationality
(Father/Live in partner) |
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Profession
(Father/Live in partner) |
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Approx
how many hours worked/week (Father/partner) |
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Age
(Father/Live in partner) |
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Level
of French (Father/Live in partner) |
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Other
languages (Father/Live in partner) |
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Family
lifestyle - Sporty, cultural, gourmet etc? |
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Which
scenarios apply to your family? |
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Describe
situations where English is NOT spoken |
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What
type of childcare have you used in the past |
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? |
Give
the pros/cons of previous Au Pair experience |
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Any
other adults living at home/staying over ? |
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Does
either parent have health issues/disabilities |
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About your home
|
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We
live in a |
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Number
of bedrooms |
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Number
of bathrooms |
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We
will provide the Au Pair with |
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? |
Do
you have any of the following pets? |
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? |
Describe
your pet(s) & any related duties |
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Does
anyone smoke in the home? |
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Do
your like to keep your home clean & tidy? |
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Explain
your ranking (fussy/too busy to notice...) |
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Do
you have any other home help? |
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? |
How
many hours a month does your cleaner work |
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Your location & contact details
|
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House
name/Number & Street |
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Town/City |
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County |
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Post
Code |
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Journey
time/cost/route to central London? |
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Where
can you collect your Au Pair from on arrival |
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? |
Mother/Live
in partner Mobile number |
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Father/Live
in partner Mobile Number |
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Secondary
Email |
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Contact
details of a referee / previous Au Pair |
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Contact
details of a referee 2 / |
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Preferred
payment Plan |
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Consult our different payment plans |
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Source
of contact |
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Attach
up to 3 family photos |
File(s)
size limit is 20MB.
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Reference
status |
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Check
up Status |
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Photos
status |
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Proposal
status |
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