Free inscription formulaire

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

Free inscription formulaire

Would you accept a family with another religion?
 yes no

Would you confirm clean police records?
 yes no

For which country you make the application?

Have you got experience with children?  yes no
Babysitter?  yes no


Do you have younger brothers and sisters?  yes no

Levels of any language:



How long have you studied the language
of the country you applied for?

Are you able to write an e-mail in the language you applied?
 yes no
Are you able to talk on the phone in this language with the family?
 yes no

How long would you like to stay?

What do you prefer: (in order)

What´s your preference for starting date?

Studies or Education

Have you ever worked?

Hobbies or interests

Do you practice any sport?

Can you play any musical instruments?

Do you like handcrafts?

What can you do?

Swimming  yes no
Skiing yes no
Horse riding  yes no
Biking  yes no

Can you do any housework?

Are you prepared to work with children?

Have you ever done babies care?

Are you ready to take care of babies?  yes no

What is your preference age?

Do you have any experience with disabled children?

Do you smoke?  yes no

By checking this I agree not to smoke in the house and in
the presence of children. I Understand that breaking this
promise means that I may be asked to leave my host family

Have you got a driving license?
 yes no

Would you be able to drive in a foreign country?
 yes no

Are you vegetarian?  yes no

Have you got any special diet habits?

Do you have any food / animals / others allergies?

Would you be able to take care of pets?
 yes no

Would you be willing to live in a family with pets?
 yes no

Would you accept to live with a single mother or a single father?
 yes no

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.