Form – palawanintlaupair.com

Name *First, Middle, Last

Country Living

Place Name

Postal Code

Phone *

Email Address *

Confirm Email

Have you worked as au pair or nanny (domestic helper) before, outside your own country?

Gender

Marital Status

Date of Birth

Citizenship

Native Language

Do you have children?

Are you presently living in your home country?

Educational Background

What is your qualification type?

Please write name and contact details of your previous/current employer/ teacher/ person who knows you well *

Do you have relatives living in Europe?YesNo

Write about your personal qualities

Specific region/town where you would like to go?

Would you accept to live in countryside?

Do you have experience in childcare?

Period

Do you have any sisters or brothers?

Their age

Do you have drivers license?YesNo

Do you have a criminal record?YesNo

Are you a vegetarian?YesNo

Can you swim?YesNo

Do you like pets?YesNo

Would you accept to work for a single parent?YesNo

Would you be willing to do housework?YesNo

Do you smoke?YesNo

Can you send a medical certificate if require?YesNo

Do you have any illnesses or handicap which might be relevant for your stay as an au pair?

Are you allergic to anything?

NAME OF THE PREVIOUS JOBS *

JOB & YEAR *

NAME OF THE PREVIOUS JOBS

JOB & YEAR

NAME OF THE PREVIOUS JOBS

JOB & YEAR

FOREIGN LANGUAGES

Letter to your future Host Family0 / 2000

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