peter pan au pairs

Au pair Registration Pack

Please print this form, answer all questions and fax/send it to:

PETER PAN AU PAIRS
The Greys
Lynsted
Kent ME9 OJW
United Kingdom

Tel: 01795 886475
Fax: 01795 886146
email: nicky@peterpan-aupairs.com

PLEASE COMPLETE IN BLACK CAPITAL LETTERS

Personal Information
Surname: First Names:
Nationality: Date of birth :
Address:  
Telephone No: Fax No:
Email: Mobile:
Religion: Do you practice it? Yes or No:
Height: Weight:


Family and home
Mother’s Occupation: Father’s Occupation:
Number and ages of brothers and sisters:


Education
Name and address of school and/or university:
Any additional qualifications:


Languages
How long have you studied English?
What is your knowledge of English (please circle)? Fluent Good Fair Poor
Other languages: (please specify)


Employment
Current Employment:
Previous Employment:


Relevant experience

Please describe fully your knowledge of child care and relevant experience:

Have you previously been an Au Pair (if so, give details):
Have you lived abroad before? Yes or No:
Do you have experience of the following household duties?
Housework Laundry Ironing Cooking Shopping


Requirement
What is your preferred age of child? 0 – 2 years 3 – 5 years 5 – 7 years 7+
Would you accept: A single parent family(male)? Yes or No      
A single parent family(female) Yes or No      
A family with no children? Yes or No      
Do you have a driving license? Yes or No      
Are you happy to drive in the UK? Yes or No      
Please list any driving convictions:


  
Do you have a criminal record (if so, please give details)


  


Other details
Are you in good health physically? Yes or No
Are you in good health mentally? Yes or No
Are you a vegetarian? Yes or No
Do you smoke? Yes or No
If yes, are you prepared to smoke outside only? Yes or No
When are you available from:  
For how long?  
Return date:  


PLEASE COMPLETE THIS FORM IN ENGLISH AND RETURN TO US WITH:

• at least two references given by persons not related to you
• a ‘dear family’ letter with information about you and your interests
• a valid Medical Certificate
• two recent photographs (smiling please!).