Application Form
Au Pair Programe in Spain
Home - Introduction - Rules - Application Form
Contact:
María Luisa Revilla
Hilarión Eslava, 29
28015 MADRID, SPAIN
Phone : 34 91 544 13 78
e-mail: revilla_aupair@hotmail.com
APPLICATION FORM
AU PAIR
PROFILE
Name and Last Name:
Address and Zip Code:
Phone & cell phone # (and best time to call)
E-mail Address
Date of birth / Age / Nationality:
Arrival date /staying for how long?:
Father’s name / age / profession:
Mother’s name / age / profession:
PERSONAL
PROFILE
Name and last name:
Studies:
Which are your plans for the future:
Describe your character:
Which are your hobbies:
Languages level: Fluent Good Medium Basic        
English        
French        
German        
Do you smoke? / Driver Licence?:
Do you swim? / Do you like animals?:
Do you swim? / Do you like animals?:
Do you have any dietary restrictions?:
Do you have any health problem?
CHILD CARE
EXPERIENCE
Have you looked after children before?
Describe:
Have you worked as an Au-Pair before?
Give an estimation of your capacities and qualities:
Do you have any special talents or skills which may be useful when responsible of children? Play instruments, Firsts Aids, summer Aids, summer camp monitor, tell histories?:
AU PAIR
DUTIES
Do you prepare children’s easy meals?:
Dusting? / vacuum? / children ironing?:
Take or pick children up from school?:
Bathing?:
Make children’s beds?:
To keep your own room neat and orderly, pick it up, and make your bed every day?:
Are you able to help with homework?:
Are you able to teach and practise the children’s English/French/German languages? Which one/s?:
DEAR LETTER
Don’t forget to send us –as soon as you can- the rest of your file: 3 Children Care References / Health Certificate / Smiling photos