Family Registration Form for an Au Pair

Family Registration Form for Au Pair, Au Pair Plus or Mother's Help

Personal Details

Full Name and Title *

Address *

Home Telephone Number *

Mobile Phone Number *

Work Telephone Number

E-Mail *

Family Details

Mother and Fathers Marital Status Single
Married
Divorced
Widowed

Fathers age

Fathers nationality

Fathers religion

Fathers occupation

Mothers age

Mothers nationality

Mothers religion

Mothers occupation

Names, Sex and Ages of Children

Newborn baby due Yes
No

Do you or your children have any medical conditions, or any other specific special needs?

What Are the Family Interests and Hobbies?

Internet Yes
No

Computer games Yes
No

Music Yes
No

Walking Yes
No

Cycling Yes
No

Horseriding Yes
No

Swimming Yes
No

Cinema Yes
No

Reading Yes
No

Please specify any Sports your Family enjoys

Any other interests

Do you have any pets? Yes
No

If so what are they

Do you require the Au Pair to help with the pets as part of his/her duties? Yes
No

How?

What Do You Want From Your Au Pair?

Do you need an... Au Pair/Au Pair +
Mothers Help

When do you need an Au Pair to start?

How long would you like an Au Pair to stay?

Will you accept a male Au Pair? Yes
No

Will you accept a smoker? Yes
No

Can they smoke in the house? Yes
No

Can they smoke in the garden? Yes
No

Can they smoke in front of the children? Yes
No

Are Driving Duties Required?

Do you need a driver? Yes
No

If yes, for what types of journeys?

Will the Au Pair be allowed use of the car for themselves? Yes
No

Is the car Manual
Automatic

Do you confirm that you will be responsible for:

Providing a roadworthy vehicle for the Au Pair to drive with full tax, MOT and insurance Yes
No

Ensuring the Au Pair has an acceptable standard of driving Yes
No

What Duties are Expected of your Au Pair?

Childcare Yes
No

Housework Yes
No

Sole charge Yes
No

Cleaning Yes
No

Playing with children Yes
No

Hoovering Yes
No

Feeding babies Yes
No

Dusting Yes
No

Simple cooking Yes
No

Washing / ironing Yes
No

Taking to / collecting from school Yes
No

Bed making Yes
No

Babysitting Yes
No

Do you have a cleaner as well as an Au Pair? Yes
No

Describe a typical days duties for your Au Pair

Salary

What will you pay your Au Pair or Mothers Help

Your Home and Area

Where is your home?

Is your home: Detached
Semi-Detached
Terraced
Bungalow
Flat

How many bedrooms?

How many bathrooms?

Does it have a garden? Yes
No

Computer / internet facilities? Yes
No

Will the Au Pair be allowed access to internet facilities Yes
No

Any other facilities?

Describe your Au Pairs Room

May the Au Pair have friends in your home? Yes
No

How long does it take to get to the following by Walking, Bus or Tube/Train?

Local shops

Bus stop

Train / Underground

Main shopping centre

Library

Restaurants

Pubs and Bars

Museums

Cafes and Restaurants

Night Clubs

And Finally...

Please describe your family and household - e.g. "we are a friendly but hectic household..."

How did you hear about Norma Lewis Domestic Staff? *

Are you registered with any other agencies, and if so which ones? *

Acceptance of terms and conditions

Terms and Conditions Link

NOW THIS FORM IS COMPLETED, PLEASE ENSURE YOU HAVE READ AND UNDERSTOOD THE "FEES" AND THE "TERMS AND CONDITIONS OF BUSINESS" OF NORMA LEWIS AU PAIR AGENCY. (YOU SHOULD KEEP ONE COPY OF THESE FOR YOUR OWN RECORDS).
SUBMITTING THIS COMPLETED FAMILY REGISTRATION FORM IN ANY FORMAT TO NORMA LEWIS AU PAIRS AGENCY SHOWS ACCEPTANCE OF THESE TERMS.

Family Name *

Date *

GENERAL INFORMATION

What Is A Nanny And What Is A Mother's Help

Openings For Agents

Agents Agreement

Testmonials

Families / Jobs Available Now

Applicants Available Now

Useful Contacts And Links

Contact Us

FOR APPLICANTS

FOR FAMILIES

Family Registration Form for Au Pair, Au Pair Plus or Mother's Help

Personal Details

Family Details

Names, Sex and Ages of Children

What Are the Family Interests and Hobbies?

What Do You Want From Your Au Pair?

Are Driving Duties Required?

Do you confirm that you will be responsible for:

What Duties are Expected of your Au Pair?

Salary

Your Home and Area

How long does it take to get to the following by Walking, Bus or Tube/Train?

And Finally...

Acceptance of terms and conditions

GENERAL INFORMATION

What Is A Nanny And What Is A Mother's Help

Openings For Agents Agents Agreement Testmonials Families / Jobs Available Now Applicants Available Now Useful Contacts And Links Contact Us FOR APPLICANTS

FOR FAMILIES

Family Registration Form for Au Pair, Au Pair Plus or Mother's Help

Personal Details

Family Details

Names, Sex and Ages of Children

What Are the Family Interests and Hobbies?

What Do You Want From Your Au Pair?

Are Driving Duties Required?

Do you confirm that you will be responsible for:

What Duties are Expected of your Au Pair?

Salary

Your Home and Area

How long does it take to get to the following by Walking, Bus or Tube/Train?

And Finally...

Acceptance of terms and conditions

Openings For Agents

Agents Agreement

Testmonials

Families / Jobs Available Now

Applicants Available Now

Useful Contacts And Links

Contact Us

FOR APPLICANTS