In order to find a suitable applicant for you, please complete and return this family questionnaire (please note it has 2 parts, both of which need to be completed), providing as much information as possible. A reference of previous or current au-pair and a photo of your family are very helpful. These can be sent via e-mail or post.

Surname:

Marital Status:

Mother:

Age:

First name:

Age:

Father:

Child`s name

Age

Sex

Education (school/nursery/childminder) hrs p/day

Address (in full incl. post code):

Work tel.:

Home tel.:

Fax:

Mobile:

Home E-mail:

Work E-mail:

Father

Mother

Occupation:

National./Ethnic origin:

Religion:

First language:

Lang. spoken at home:

Do you smoke:

Family hobbies:

Family pets:

Health of the family members (details of any problems):

Do you have any dietary restrictions:

Please describe your accommodation (type, no. of bedrooms, bathrooms, garden, area):

Their nationality and lengths of stay:

Have you had an au-pair before:

Please state any other details about your family, which you think may help us select 

the most suitable applicant:

PLEASE PRESS THE "SUBMIT" BUTTON WHEN COMPLETED. If we do not contact you within 2 days, this means we have not received the submission perhaps due to some technical problems.