Au Pair Registration Form

First name
Last name
Date of birth
How did you hear about us
Languages spoken(in order of fluency)
Suburb/ City
Mobile phone
Position applying for Please note we ONLY do live in placements
Can you commit to minimum 6 months with a family?
Start date
How long can you work for a family
How long will you be in Australia?
Will you study here?
What are your study hours each day – start and finish times
What type of visa do you have?
Visa number
Do you smoke?
If yes how many per day?
Are you in good health?
If not, please explain
Do you have a special diet? If so please describe
Would you be prepared to work for a single parent?
Would you like to be with a stay at home mum?
Would you like to be with a family where both parents worked?
Can you cook simple meals?
Can you swim?
Would you be prepared to work with children with disabilities?
Have you worked with children under 2?
Have you changed nappies?
Would you be prepared to do 1-2 hours per day of light housework?
Are you OK with house pets?
Do you have any allergies? Please describe
Do you have a valid driver’s license for your country?
Date of issue
Can you drive a manual / automatic car or both?
Can you obtain an international drivers license before you arrive here?
Level of English
Do you have any criminal record? Please describe
Would you be prepared to live with a family outside the metropolitan area?
What is your highest level of education and qualifications (Particularly in childcare)
Please describe your experience with children and ages it relates to.
What age do you have experience with?
Which advertised jobs are you interested in?
What age would you prefer to work with? Please note you would not be left alone with children less than 1 year unless qualified to do so.
What are your hobbies and interests?
I certify everything is true and correct on this form
I herewith agree to help the host family with their children and light house-work for the agreed hours per week. Furthermore I agree to baby sit the children in the case of a different job contract. I will also accomplish my duties as well as I can and obey the laws of the host country. I will accept the customs of the host country and I agree to adjust to them.
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