QUALITY LINK LIMITED - Au Pair Application Form

Please note compulsory fields are marked with an asterisk (*).

A - PERSONAL AND CONTACT INFORMATION

Full Name *

Date of Birth *

Address *

City/Town *

B - EDUCATION AND EMPLOYMENT HISTORY

Academic Qualifications with Dates *

Present Employment *

C - HEALTH

Do you smoke? *	If Yes, how many do you smoke in a day

Are you able to avoid smoking in the house? *

Do you have any diseases or allergies? *	If Yes, specify

Do you have any special dietary requirements? *	Are you vegetarian?

Are there any pets that you are unable to live with? *	If Yes, specify

D - CHILDCARE EXPERIENCE/SKILLS

What age group of children are you experienced with? *

Is there any group of children that you are not comfortable with? *

Do you have a valid drivers license? *

Are you willing to drive in Britain *

Do you speak any foreign language? *

How long have you been learning English ? *

E - PLACEMENT REQUIREMENTS

When do you want to start your au pair job? *

How many months do you want to stay? *

Where would you like to live? *

Are you willing to stay with a single parent family? *

Are you willing to live with a family of a different race? *

F - FAMILY BACKGROUND

Fathers Full Name *

Mothers Full Name *

Do you have any brothers or sisters? *

If Yes, Please give details of their age(s) and occupation

Do you live alone with your family? *

Do you live in a flat or house? *

Will you consider to care for disabled children?

Do you have any experience with disabled children? *

What household duties can you perform? *

Do you have any of the following specialized skills? *

Do you swim? *

How often do you drive? *