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Au-pair

Family

Register family

1. Surname:

2. Street:

3. ZIP code: town/city:

4. Land (FRG):

5. Country:

6. Phone number:

7. Fax:

8. ICQ :

9. e-Mail:

10. What time is the most suitable to call you?

11. Family members:

Host family	Surname	Name	Date of birth	Nationality
Father:
Mother:

Children	Name	Date of birth	Age	Gender
1:
2:
3:
4:
5:

12. Are there anybody else living in your house?

Yes No

13. If yes, please name, who:

14. Do you have invalids in your family?

Yes No

15. When has an Au-pair to arrive?

the earliest:
the latest:

16. How long has an Au-pair to stay with your family?

17. Will you accept a summer Au-pair (for 2-3 summer months)?

Yes No

18. Do you have any requirements to the invited Au-pair's religion?

Yes No

19. If yes, then what are they?

20. Would you accept a male Au-pair?

Yes No

21. If no, then for what reason?

22. Do you smoke?

Yes No

23. Will you allow your au-pair to smoke in your presence?

Yes No

24. If yes, is he/she allowed to smoke in his/her room?

Yes No

25. Must an au-pair have a driving licence?

Yes No

26. Is an au-pair allowed to drive your car?

Yes No

27. What other languages are spoken in your family?

28. Would you accept an au-pair with satisfactory language sills?

Yes No

29. If yes, then what other languages has he/she to speak?

30. What is the role of religion in your family?

31. Are you vegetarians?

Yes No

32. Can an au-pair be a vegetarian?

Yes No

33. Do you have other dietary habits?

34. Do you have a TV?

Yes No

35. Is an au-pair allowed to watch it?

Yes No

36. How will an Au-pair be located in your house?

37. Please, give a brief description of your residence.

38. How many people live in your house?

39. Is an au-pair supposed to have free time, opportunity to do shopping and to get necessary medical care?

40. What visa department and labour exchange are the most suitable for you?

	ZIP code	City/town	Pnone number	Fax.
Visa department
Labour exchange

41. Remoteness of your residence from the downtown?

42. Remoteness from the nearest big city (name)?

43. Remoteness from the nearest language school ?

44. Location and type of the school (e.g. evening school)

45. Distance to the nearest transport?

46. Is your residence location covenient relatively to the local transport?

Yes No

47. What kinds of local transoprt are meant?

48. Could an au-pair have a bicycle?

Yes No

49. When and how often can an au-pair attend language courses?

50. Will you finance language courses?

Yes No

51. If yes, then how big can be the amount of money assistance?

52. Wil you assume travelling expenses?

Yes No

53. If yes, then what is the highest degree?

54. Do you have pets?

Yes No

55. If yes, then what animals do you have?

56. Has an au-pair to look after pets?

Yes No

57. Family hobbies

58. What family hobbies can an au-pair take part in?

59. Do you have any music instruments?

Yes No

60. If yes, then which an au-pair can play?

61. Do you wish an au-pair to take active part in family life?

Yes No

62. What help do you expect to get from an au-pair (exact information, please)?

63. Has an au-pair to work and study with children daily?

64. When do you need au-pair's help the most?

	////	the latter half of the day from/to	evenings from/to
Monday-friday
Weekend

65. The daily routine:

66. What day is free?

67. Can an au-pair be free on holidays?

68. Host father's profession:

69. Time when father is outside house from:

h. till h.

70. Host mother's profession:

71. Time when mother is outside house from:

h. till h.

72. Time when the child is outside house from/till

Child	School	Kidergarten	Sport sections:	?..( )
1
2
3
4
5

73. Will you ask your au-pair to execute any additional housework?

Yes No

74. If yes, then how often??

75. How many au-pairs have you accepted in your family already?

76. Are there any peculiarities in your working days that you wish us to take to account while choosing an au-pair for you?

77. What would you like your future au-pair to know about you?

78. Type the number, please.

We confirm that all the information provided is true and definitive. We also claim that we have familiarized with the German agencies informationals, labor and price agreements and we agree to it. We engage to pay out the commission shop to InnovaConsult in the case of a trap and we confirm here that we will provide an au-pair at least with pocket money, insurance, food and habbitation.
All the data provided will be handled and will be kept until collaboration taking place.

Yes No