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. It's going to take ~15 minutes. You ready?
What is your first name? *
Your answer
What is your last name? *
Your answer
What street do you live in? *
Your answer
Which house number? *
Your answer
What is your postcode? *
Your answer
Which city do you live in? *
Your answer
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? *
Your answer
Are you married? *
What is your partner's nationality?
Your answer
What is the main language spoken in your home? *
Your answer
What is your religion or spiritual practice? *
What are your professions? *
Your answer
Have you previously hosted an au pair? *
How many au pairs have you had before? *
Your answer
How many children will be under the care of the au pair? *
Your answer
What are the ages of your children? *
Your answer
How many girls do you have? *
Your answer
How many boys do you have?
Your answer
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? *
Your answer
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? *
Your answer
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 *
Your answer
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 *
Your answer
Message to your future au pair (Please write at least 5 lines.) *
Your answer
Which phone number and email address would you prefer to be used for any further communication? *
Your answer
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