International Au Pair Italy

THE BEST EXPERIENCE YOU CAN HAVE!

We request that you complete the form to help you build the best possible experience abroad. We remain at your disposal for any information or details you may need.

Personal Info

Name *

Surname *

E-mail (username) *

Password *

Telephone nr. (without international code) *

Date of Birth

Place of Birth

Country of Citizenships

Gender

Female Male

Do you smoke?

yes no

Driver ?

yes no

Are you willing to drive abroad?

yes no occasionally

What is your religion, pls.?

Program

Country Requested (I)

Country Requested (II)

Country Requested (III)

Can you swim?

yes no

Do you have previous experience in childcare?

yes no

Summarize your overall experience with children, pls.

Earliest start date

Latest start date

Legal & Study

Have you ever been charged or convicted of a criminal offence?

yes no

Studies performed

Diet & Health

Do you have any chronic or recurring health problems? For example: asthma, diabetes, cold sores…….?

yes no

Do you have any allergies (include pets)?

yes no

Have you been hospitalised or under the care of a doctor within the last 12 months?

yes no

Are you currently receiving, or have you received, any psychiatric or psychological treatment?

yes no

Are you on a particular diet?

yes no

Would you agree to undergoing a test for aids/HIV?

yes no

Family Preference

Would you accept a single parent family?

mother father either neither

Would you accept a family with a different religion?

yes no it depends

Are you ready to take care of disabled children?

yes no it depends

Do you like animals?

yes no it depends

Could you consider to share your room with the children?

yes no

How much experience do you have with please select:

looking after children aged 0-2?

good some none

looking after children aged 3-7?

good some none

looking after children aged 8-12?

good some none

looking after disabled children?

good some none

keeping children occupied (play with them)?

good some none

doing light housework?

good some none

washing/ironing clothes?

good some none

cooking simple meals?

good some none

looking after pets?

good some none

Special wishes and/or important remarks for your placement:

Privacy Policy

I agree with the Privacy Policy of this site

Pls. sum up and write the total

5+4 =

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Personal Info

Name *

Surname *

E-mail (username) *

Password *

Telephone nr. (without international code) *

How did you hear about us? (Please select one)

Date of Birth

Place of Birth

Country of Citizenships

Gender

Do you smoke?

Driver ?

Are you willing to drive abroad?

What is your religion, pls.?

Program

Country Requested (I)

Country Requested (II)

Country Requested (III)

Can you swim?

Do you have previous experience in childcare?

Summarize your overall experience with children, pls.

Program Type

Program Lenght

Earliest start date

Latest start date

Legal & Study

Have you ever been charged or convicted of a criminal offence?

Studies performed

Diet & Health

Do you have any chronic or recurring health problems? For example: asthma, diabetes, cold sores…….?

Do you have any allergies (include pets)?

Have you been hospitalised or under the care of a doctor within the last 12 months?

Are you currently receiving, or have you received, any psychiatric or psychological treatment?

Are you on a particular diet?

Would you agree to undergoing a test for aids/HIV?

Family Preference

Would you accept a single parent family?

Would you accept a family with a different religion?

Are you ready to take care of disabled children?

Do you like animals?

Could you consider to share your room with the children?

looking after children aged 0-2?

looking after children aged 3-7?

looking after children aged 8-12?

looking after disabled children?

keeping children occupied (play with them)?

doing light housework?

washing/ironing clothes?

cooking simple meals?

looking after pets?

Special wishes and/or important remarks for your placement:

Privacy Policy

Pls. sum up and write the total