Free sign-in questionnaire

You can fill up this questionnaire on-line or download a printable version by clicking the PDF icon:

Free inscription formulaire






How many hours will the Au pair be alone at
home with the children?

Do you have any disabled child?
 yes no

Do you attend any religious service?
 yes no

Do you live in an apartment or a house?

Please, make a brief description of your house

Do you have a room for the Aupair?  yes no
Is there enough Light and room?  yes no

Do you have any public transportation to
arrive to the city centre?

What date would you like the Aupair to arrive?

How long do you need the Au pair to stay?

How many hours daily?

What tasks will she have?

What duties will she have with children?

What language would you like the Au pair
speak with the children?

What language is mainly spoken in your family?

Do you smoke at home?
 yes no

Would you accept a smoker who will respect the
domestic places and children?
 yes no

Do you have any pets?
 yes no

Would you like the Au pair to take care of your pets?
 yes no

Another daily tasks for the Au pair

Will you accept her as a member of the family?
 yes no

Will you agree the weekly salary with the agency
according to the number of worked hours?

Write a short welcome message for the Au pair.
You can add a brief family description.

What are the main characteristics you think
an Au pair should have?

make the list of preference of nationalities.

By checking this I herewith confirm that all my statements
concerning my application are true. I am aware that my
application and the enclosures cannot be returned to me.