Au Pair Registration Form

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Thank you very much for your interest in joining Culture Online! We place Au Pairs mostly in the Netherlands but we do place Au Pair candidates all over Europe. Please complete the form and give your best in answering all of the questions.

First Name *

Last Name *

Gender *

Female

Male

Age *

Contact Mobile Number *

Contact Email Address *

Video/Web Conferencing Contact Info *

Please provide your Skype ID or Zoom you prefer to be used for initial talk

Facebook Link *

Nationality *

Educational Background *

High School Graduate

College Undergraduate

College Graduate

University

Other:

University Degree | Your Professions *

Languages Spoken *

How is your health condition? *

Do you have a passport? *

Yes

Other:

Have you travelled abroad? Please provide more information. (Which country and your reason for travel) *

When is the earliest possible date that you can start being an Au Pair? *

YYYY

What motivates you to become an Au Pair? *

Child Care Preferences *

Given the choice, what are the age groups that you prefer working with? Please select all that apply.

0-3 months

3-6 months

6-12 months

12-18 months

18-24 months

2-5 years

5-10 years

Over 10 years

Required

Please select all the traits that best describe YOU. *

Spontaneous - does not spend much time or effort in planning activities in advance

Organized - prefers to have all activities planned and scheduled in advance

Adventurous - prefer to explore and try new things

Conservative - prefers to do things that you are familiar or comfortable with

Assertive - prefer to openly express yourself, and your thoughts and opinions

Passive - prefers to keep your thoughts and opinions to yourself

Outgoing / Extrovert - prefers to go out, and meet new people

Reserved / Introvert – prefers to keep to yourself, enjoys alone time or smaller groups

Flexible - okay with making changes and adjustments as needed

Rigid - prefers to stick to an established schedule/routine and dislikes making changes

Creative - prefer to think out of the box and be imaginative in solving problems

Logical - prefers to solve problems by being rational; decisions are well thought out and calculated

Direct - prefers to be straight-forward, even if it may lead to an argument or disagreement

Non-confrontational - avoids speaking up to avoid arguments and disagreements

Energetic - has high energy, always on the move, and is doing something

Calm - prefers a slow-paced approach; is disciplined and thoughtful with your actions

Firm - prefers to be authoritative and have a disciplined environment; prefers things to be done your way with little negotiation

Gentle - open for discussions and is democratic on discipline and requests

Serious - prefer the host kids to think of you more like a parental figure

Fun-loving - prefer the host kids to think of you more like an older sibling or friend

Required

Please select traits that you DO NOT want in a Host Family. *