Full service host family intake form
This form is all about you, your family and home and of course what you expect from the au pair. The au pair program is primarily a cultural exchange. We need to know how you will make the year with an au pair an amazing cultural exchange.  It's going to take some time and thought. Are you ready?
Sign in to Google to save your progress. Learn more
Email *
What is your first name as it appears in your passport? *
What is your last name? *
What street do you live in? *
Which house number? *
What is your postcode? *
Which city do you live in? *
Do you live in a city, or in a small town? *
Do you have a spare bedroom of at least 9m2 with a window that can open? *
Does this spare bedroom have unrestricted access to a bathroom and WC? *
What is your nationality? *
Are you married? *
What is your partner's nationality? *
What is the main language spoken in your home? *
The au pair program is a cultural exchange program for the au pair. Please write a paragraph (~200 words) on how you will make this year a cultural exchange for the au pair in your home. *
What is your religion or spiritual practice? *
What are your professions? *
Have you previously hosted an au pair? *
How many au pairs have you had before? *
How many children will be under the care of the au pair? *
What are the ages of your children? *
How many girls do you have? *
How many boys do you have? *
What would you like your au pair to do with the kids? *
Required
What sort of activities do your children enjoy? *
Required
Do any of your kids require special care? *
Do you or your partner smoke? *
Do you have pets at home? *
Required
In what age range would you like your au pair to be? *
Which nationality do you prefer for your au pair? *
Required
Your au pair should be able to speak this language fluently *
Required
Start date au pair *
End date estimated *
MM
/
DD
/
YYYY
How long would you like your au pair to stay? *
Does your au pair need to have a drivers licence? *
Do you expect the au pair to help with chores around the house? *
What would you like the au pair to do around the house? *
Required
Is it ok if the au pair smokes? *
Would you find it difficult to host an au pair with any of these dietary preferences? *
Required
What religious values would you prefer your au pair to have? *
What type of au pair are you looking for? *
Other requirements we should know about? Anything non-negotiable? *
Write a letter to your future au pair. Why would you be a great host family for an au pair? *
Which phone number and email address would you prefer to be used for any further communication? *
How did you hear about us? *
Do you have a coupon code?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Nina.care. Report Abuse
Google Forms