Host Family Registration Form
Thank you for your interest in working with Culture Online! It is our pleasure to help you find the right candidate. Please fill in this registration form and our team will guide you through all the steps involved in the program. We will be in touch with you for us to understand your expectations in hosting an Au Pair and also, we would like to get to know more about your family.
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Email *
First Name *
Last Name *
Contact Mobile Number *
Contact Email Address *
Video/Web Conferencing Contact Info *
Please provide preferred platform for Au Pair Initial Talk (Skype ID, Zoom, WhatsApp)
Living Address *
Street, House Number, Post Code
Are you married? *
What are your professions? *
What is your nationality? *
What is the main language spoken in your home? *
What is your religion or spiritual practice? *
Do you or your partner smoke? *
Do you have pets at home? *
If Yes, Please specify at others
Have you hosted an Au Pair before? *
We have found our own Au Pair *
Do you have a preference on the nationality of the Au Pair you would like to host? If you do, please provide us with the nationalities and provide a reason for your preference. *
Please list the number, gender and ages of your children : *
Do any of your children require special care? *
Are the Host Parents in good health condition? *
Does anyone in your family have any allergies? If your answer is yes, please provide more details. *
What activities would you like your Au Pair to do with the children? *
Please select all the traits that best describe your family. *
Please select the traits that you DO NOT want in an Au Pair. *
Please select the traits that you DO want in an Au Pair. *
Please tell us more about your family.
A copy of your responses will be emailed to the address you provided.
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