Child Care Solution

AU PAIR REGISTRATION IS A TWO STAGE PROCESS

Complete this form and submit it to us.
Send the following items separately:

2 references
1 passport photograph
A letter of about 250 words in English introducing yourself to your prospective host family

If possible additional photographs showing yourself with any children you have cared for and your own family

The additional information should be sent as soon as possible after the submission of you registration form to the address on the
contact information page. Please remember that this service is free of charge and sometimes it takes a few weeks to match you with a suitable family, it is most important that you inform us immediately of any change in your availability.

You must fill in all of the fields on the form. If the question does not apply to you enter 'none' or 'na' in the box.

Earliest date of availability
For how long are you available

Personal Details

Full Name
Home Address
Postcode
Home Telephone Number
Work Telephone Number
Fax Number
E-Mail
Date of Birth
Gender
Occupation
Nationality
Marital Status

Details About your Next of Kin

Religion
Name and Address of your Next of Kin
Telephone number of Next of Kin
Mothers Occupation
Fathers Occupation
Brothers and Sisters, Please give their ages!
What Level is your English?	Fluent Fair Elementary
Do you speak any other languages

Driving

Have you passed your driving test?	yes no
Date of test
Do you have a clean licence	yes no
If not, please give details
Are you happy to drive in the UK	yes no

Please tick the boxes that best describe your driving ability

If you will be driving in the UK please remember to obtain your International Driving Licence before leaving your home country.

Smoking

Do you smoke?	yes no
If yes, how many per day
If you smoke are you prepared to smoke only when you are off duty and outside of the house?	yes no

Child Care Experience

Please tell us about your child care experience
Infants (0-12 months)
Toddlers (1-3 years)
Pre School (4-5 years)
Youngsters (6-8 years)
Older (9+)
Handicapped Children

Do you have experience with (please tick at least one)

cooking cleaning ironing housework none

Can You Swim?	yes no
What Musical Instruments do you play?
What sports do you play?
What are your hobbies and interests?

Health

Do you have any emotional or health problems which may affect your work?
Do you have any allergies, including allergies to pets?
Are you willing to take a post where the family have pets?	yes no
If you are a vegetarian will you cook meat for other family members?	yes no

Criminal Convictions
The agency licensing authority now require us to ask the following question:

Have you ever engaged in legally defined criminal activities or have you ever been convicted of a criminal offence?
The completing and submitting of this form will be deemed an acceptance of our Au Pair Guidelines and Conditions.

Terms and Conditions

theChildCareSolution/WorldNetUK and its associates (The Agency) act as introductory agents. The Agents will endeavour to offer applicants positions to suit their requirements and experience, and whilst ensuring to the best of its ability the bona fide nature of prospective families offered, the Agency is in no way liable should the an au pair be subsequently dissatisfied with the ensuing appointment.

The Agency cannot and does not accept responsibility for any damage to health or possessions or for any loss of earnings or expenses incurred in connection with any introduction by the agency