Host Family Application

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1Au Pair or Demi Pair

2Family Details

3Family Home Address

4Details of Children

5Facilities & Schedule

6Letter, Photo & Confirmations

We are seeking a *

Preferred start date for Au Pair/Demi Pair *

Driver required *

Family Details:

Parent #1 Name *

First

Last

Parent 1 Age *

Parent 1 Nationality *

Parent 1 Occupation *

Parent 1 Contact number (mobile): *

Parent 1 Email *

Parent 1 Gender *

Male
Female
Other
Prefer Not to say

Are you a Single Parent family? *

Would you like to add an additional parent? *

Parent #2 Name *

First

Last

Parent 2 Age *

Parent 2 Nationality *

Parent 2 Occupation *

Parent 2 Contact number (mobile): *

Parent 2 Email *

Parent 2 Gender *

Male
Female
Other
Prefer Not to say

Does any member in the household smoke/vape? *

Have you or any member of your immediate family been convicted of any criminal offence other than a minor traffic violation? *

As you selected Yes to a criminal offence, please describe. *

I/ We understand that every adult living in the family home will be required to provide a current Police Clearance Certificate to participate in the program. *

Family Home Address:

Street Address *

Suburb *

Postcode *

State *

Type of residence:

Number of persons residing in family home: *

Number of bedrooms *

Number of bathrooms *

Do you have a swimming pool? *

Describe the area you live, including distance to nearest bus/train stop and any recreational facilities, beach, shopping centres etc: *

Details of Children:

Name, Gender and age of all children living in family home. *

Please note: We do not recommend Au Pairs / Demi Pair's have sole charge for children under 2 years of age.

Does any member of the household have special needs? *

If so please explain: *

Any allergies within the household *

If so describe the allergies: *

Language spoken at home: *

Have you had a live in Au Pair/Demi Pair before? *

Do you have any pets? *

Please describe your pets: *

Au Pair/Demi Pair's facilities:

Please tick which facliities your Au Pair/Demi Pair will have... *

Own bathroom
Car available for personal use
Eat with children only
Eat with family
Join family activites

Au Pair/Demi Pair's Work Schedule:

Please list your days and times you require your Au Pair/Demi Pair to assist with: *

Please tick which duties you require your Au Pair/Demi Pair to assist with... *

Childcare duties
Bathing and dressing the children
Playtime and activities with children
General tidying after playtime with children
Assist with homework
Driving or walking the children to school/day-care/activities
Preparing food and supervising at meal times
Cooking light meals

Please list any other duties you require your Au Pair/Demi Pair to assist with *

Please compose an introductory letter to your prospective Au Pair/Demi Pair describing your family and interests: e.g. a typical weekend. *

Attach one JPG image of you and your family. *

Click or drag a file to this area to upload.

Max size 8mb. JPG/JPEG or PNG images allowed.

We understand that the above information will be sent to potential Au Pair/Demi Pair candidates in a password protected file. *

In accordance with Global Data Protection Regulation (GDPR), which affects all European/UK candidates we require you to delete all details (files, photos) relating to a Candidate at the first possibility when no longer actively required. Please delete, immediately all files of Candidates with whom you are not entering into an agreement. *

We agree & understand

Please tick box *

I confirm I have read and accept the Families Terms & Conditions of business as specified by Au Pair & Nanny Network Australia.

If you have issues submitting this form please contact us directly by phone: 0424 442 695 or email admin@aupairnetwork.com.au

Application to host an Au Pair or Demi Pair.

Family Details:

Family Home Address:

Type of residence:

Details of Children:

Au Pair/Demi Pair's facilities:

Au Pair/Demi Pair's Work Schedule:

Embark on a journey of cultural exchange with our Au Pair and Demi Pair programs!

Au Pair & Nanny Network Australia an Au Pair agency based in Perth WA that has provided a professional recruitment service offering families high quality and affordable childcare solutions since 2010.

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