Au Pair Registration Form
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.
* Required
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Female
Male
Age
*
Your answer
Contact Mobile Number
*
Your answer
Contact Email Address
*
Your answer
Video/Web Conferencing Contact Info
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Please provide your Skype ID or Zoom you prefer to be used for initial talk
Your answer
Facebook Link
*
Your answer
Nationality
*
Your answer
Educational Background
*
High School Graduate
College Undergraduate
College Graduate
University
Other:
University Degree | Your Professions
*
Your answer
Languages Spoken
*
Your answer
How is your health condition?
*
Your answer
Do you have a passport?
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Yes
No
Other:
Have you travelled abroad? Please provide more information. (Which country and your reason for travel)
*
Your answer
When is the earliest possible date that you can start being an Au Pair?
*
MM
/
DD
/
YYYY
What motivates you to become an Au Pair?
*
Your answer
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.
*
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 want in a Host Family. Please select up to five traits.
*
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 tell us more about you
*
Your answer
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