Due to increasing demand for Au Pairs, we cannot process any inquires without the £25.00 registration fee.

Cheques made payable to Au Pairs Direct or pay by Credit Card online

Au Pair placement required:

Start Date

Duration of Stay

First Name

Family Name

Address Line 1

Address Line 2

City

Country

Postcode

Nearest Airport

Home Telephone

Work Telephone

Mobile Phone Number

Fax Number

E-mail

Husband's Occupation

Husband's Nationality

Wife's Occupation

Wife's Nationality

Marital Status:

Please give name, date of birth and sex of child.

Do you have any children with a handicap or disability?

Family Hobbies

Religion of Household

Languages Spoken

Would you prefer a smoker or non smoker?

Do you have any pets?

Please state the distance from your home to the nearest:-

Bus/Train station

English School

Shops

Do you require a driver?

Do you provide a car?

Do you require a swimmer?

Would you accept an Au Pair who
did not speak very good English?

Do you object to a vegitarian Au Pair?

Do you have any domestic help?

How many bedrooms do you have?

Is there a separate room for the Au Pair?

Please describe the Au Pair's accommodation in full. ie. own toilet, bathroom, television, radio etc

Please outline duties
(describe a typical day for your Au Pair)

Average working hours per day?

Average working hours per week?

Number of evenings babysitting a week?

Would you accept a male Au Pair?

Pocket Money (Home Office recommend £65 a week)

Have you engaged an Au Pair before?

If yes, how many and what nationality?

Additional Information

Where did you hear about Au Pairs Direct?

Registration by Credit Card, please give details:

Type of card

Card Number

Expiry Date

Issue Number

I/We declare that the above information is true and correct and any untrue statements may stop all placements. I/We have read the terms and conditions of the agency and agree to adhere to them. The registration fee is enclosed with this registration.

I have read the Terms and Conditions