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Beck 0424 442 695 (WA)
(Office hours only) Monday - Friday 9am - 5pm

Application to host an Au Pair or Demi Pair or Elderly Companion.

 * Required Fields

General Information

(Mandatory for all family members 18 years and over.)

(Mandatory for all family members 18 years and over.)


Details of Children:

Please select the number of childern you have in each of the boxes below:

Child #1:
Child #2:
Child #3:
Child #4:

Please note: AuPairs cannot have sole charge for childern under 2 years of age


Family Home:


Family Requirements:


Au Pair's facilities:


Au Pair's work schedule:

Please tick which duties you require your Au Pair to assist with...
Childcare Duties. Tick box
Light household duties. Tick box

Please compose a introductory letter to your prospective Au Pair.


Please note: if you have issues submitting this form please contact us directly by phone: 0424 442 695 or email