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REGISTRAZIONE
Norme per gli au pair
IN PARTENZA
FAMILY
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REGISTRAZIONE
Norme per la famiglia
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Family application form
Please, read the
rules page
before registering, thank you!
Compila il questionario in inglese, grazie!
Step 1
Family's details
Family name
Whatsapp
Mobile phone
Home Phone
Skype
Email
Step 2
Address Details
Address
City
Province
CAP
Step 3
Host Family Parent 1
Name
Occupation
Religion
Nationality
Afghan
Albanian
Algerian
American
Arab
Argentinian
Australian
Austrian
Belgian
Belarusian
Bolivian
Bosnian
Brazilian
British
Bulgarian
Cambodian
Canadian
Czech
Chilean
Chinese
Cypriot
Colombian
Korean
Croatian
Cuban
Danish
Egyptian
Estonian
Ethiopian
Filipino
Finnish
French
Welsh
Jamaican
Japanese
Greek
Indian
Indonesian
English
Iraqi
Iranian
Irish
Israeli
Italian
Latvian
Lithuanian
Malaysian
Moroccan
Mexican
Moldavian
New Zealander
Nigerian
Norwegian
Dutch
Pakistani
Palestinian
Peruvian
Polish
Portuguese
Puerto Rican
Romanian
Russian
Scottish
Senegalese
Serbian
Syrian
Slovenian
Somali
Spanish
South African
Swedish
Swiss
Thai
Taiwanese
German
Turkish
Ukrainian
Ugandan
Hungarian
Uruguayan
Venezuelan
Vietnamese
Yemeni
Zimbabwean
Step 4
Host Family Parent 2
Are you a single parent?
Yes
No
Name
Occupation
Religion
Nationality
Afghan
Albanian
Algerian
American
Arab
Argentinian
Australian
Austrian
Belgian
Belarusian
Bolivian
Bosnian
Brazilian
British
Bulgarian
Cambodian
Canadian
Czech
Chilean
Chinese
Cypriot
Colombian
Korean
Croatian
Cuban
Danish
Egyptian
Estonian
Ethiopian
Filipino
Finnish
French
Welsh
Jamaican
Japanese
Greek
Indian
Indonesian
English
Iraqi
Iranian
Irish
Israeli
Italian
Latvian
Lithuanian
Malaysian
Moroccan
Mexican
Moldavian
New Zealander
Nigerian
Norwegian
Dutch
Pakistani
Palestinian
Peruvian
Polish
Portuguese
Puerto Rican
Romanian
Russian
Scottish
Senegalese
Serbian
Syrian
Slovenian
Somali
Spanish
South African
Swedish
Swiss
Thai
Taiwanese
German
Turkish
Ukrainian
Ugandan
Hungarian
Uruguayan
Venezuelan
Vietnamese
Yemeni
Zimbabwean
Step 5
Children
Name, age and sex of all children
Any Special Needs?
Yes
No
Please explain
New baby expected?
Yes
No
Family hobbies and interests
What languages are spoken at home?
Italian
English
Spanish
German
Russian
Arabic
other
Does any member of the household smoke?
Yes
No
Any specific family dietary information?
Is your family in good health?
Yes
No
Please, specify
Other House Persons
Yes
No
Who?
Do you have pets at home?
Yes
No
Which?
Do you wish your applicant to care for your pets?
Yes
No
Step 6
Family Home
Type of House
What is your location like?
Big city
Medium city
Small city
Countryside
Mountain
Sea
other
Do you employ domestic staff?
Yes
No
Please indicate hours
Please indicate how essential it is for you to have a clean and tidy home?
Low
Normal
High
Nearest Train Station Distance
Nearest Bus Routes Distance
Nearest airport
Step 7
Applicants facilities, privileges
Single Bedroom
Yes
No
Private bathroom
Yes
No
Use of Internet
Yes
No
Weekly Pocket Money
Yes
No
Room Description
Is there a language school nearby?
Yes
No
Step 8
Childcare
Childcare Duties
Childcare Skills
Household Duties
Step 9
Placement Description
Required Starting Date
Length of stay
Category of help
Hours on duty per week (to include babysitting)
Average babysitting evenings per week
Free days
Other benefits
Preferred applicant
Aupair
Language Tutor
Nanny
Live out babysitter or Teacher
Will you accept a smoker?
Yes
No
Driver required?
Yes
No
Step 10
Prior live-in experience
Have you had live-in help before?
Yes
No
Previous Applicant Name
Previous Applicant Year
Previous Applicant Contact
Description of what you expect from your aupair/Tutor
Description of our family
Family Letter
Attachments, Images
Please, only jpg or jpeg and max size 5 MB
While every care is taken in introducing families, the agency is not responsible for any problems arising. I have Read all the information and accept the conditions of this agency. I hereby declare that the information given on this form and the enclosed documents are true in every respect.
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