Personal Details

First Name

Last Name

Sex

Age

Date of Birth

Height

Weight

Nationality

Passport number & Expiry

Marital Status

Contact Details

Address 1

Address 2

Town/City

State/Province

Postal code

Country

Home Telephone

Work Telephone

Mobile

Fax Number

Email Address

Placement Details

What date do you wish to start your placement?

What is the latest date that you can start?

How long do you wish to stay for?

Family Details

Fathers Profession

Brothers / Sisters age(s)?

Education

Please give a brief description of your education, the subjects you have studied and enjoyed, your qualifications and any other information you consider relevant.

How many years have you studied English?

What is your level of spoken English?

What other languages do you speak?

Do you wish to attend English class?

Childcare and Family Home Experience

Please describe, in detail, the jobs you have done for the last 3 years and your childcare experience.

Would you consider a family with...

Which ages of children will you care for?

Would you accept a single mother?

Would you accept a single father?

Driving

Do you have a driving license?

Will you drive in the UK?

Please note that if you wish to drive in the UK we will need a copy of your driving license, the date you passed your driving test, details of any previous accidents, insurance you have held in your name and details of your driving experience at home and abroad if relevant.

Health

Do you smoke?

If 'Yes', how many per day?

If you smoke, would you be prepared to not smoke in the family home?

Do you have any illness or injuries?

If 'Yes' could you give details?

Will you go to family with Cats & Dogs?

Do you have allergies?

If 'Yes' could you give details?

Are you a Vegetarian

Would you accept a non-vegetarian family?

Can you swim?

Work Duties

Are you able to carry out the following duties?

Cleaning?

Cooking?

Ironing?

Gardening?

Area Preferences

Would you accept a position in...

Will you only go to a specific area?

If 'Yes', please give details, and the reason why you prefer to be there.

Previous Travel

Have you travelled to other countries before?

If 'Yes', please give details.

Have you lived away from home before?

If 'Yes', please give details.

Have you been to, or are you in the UK?

If 'Yes', please give details.

Other Interests

Could you please describe your other interests, hobbies and pastimes?

Other Information

Do you have any visible tattoos or body piercing?

If 'Yes', please give details.

Do you have a criminal record?

If 'Yes', please give details.

Acceptance of Terms & Conditions

IMPORTANT
All of the information you have given us on this form will help us to find the best family for you. Please also send by post (to us) a doctor's certificate to say that you are fit and healthy, 2 references from people that you have worked for/ or whose children you have cared for/ or a former teacher. These will be checked by Aupairs and Nannies International Ltd. Please also write a letter of introduction about yourself, your hobbies and your background to introduce you to the family. You should also email or send 4 passport size photographs with your name on the reverse.

Please remember that when you come to the UK you should always have a return ticket and enough money for emergencies. Whilst we will try to help in an emergency it is not always possible, and you are your own responsibility.

I confirm that I have read and understood all of the above, and that I have answered all questions fully and honestly to the best of my knowledge. I confirm that I am not married and have no children as required by the aupair scheme.

Please now click on the Submit button.
Note: clicking on the Submit button indicates your acceptance of our terms and conditions of business.

Thank you for completing our registration form.

If you would prefer to send this form by post, could you please print out the form and return it to us.

Could you please sign and date the form and return it to us. Please note: Signing and dating this form indicates your acceptance of our terms and conditions of business.

Could you please send the completed form to:

Aupairs and Nannies International Ltd,
Pantiles Chambers
85 High Street
Royal Tunbridge Wells
Kent
TN1 1XP

Tel: 0207 754 0055
Fax: 01892 506862