First Name: / Last Name:
Full Address: / Email
Home Tel with country & area codes: / Mobile Tel :
Marital Status:
I accept living in : / City / Town / Country
I am available to start on; / Month / year
Is this date flexible? would you accept to start before? pls give details / Yes / No
Choose from one of the 3 programs we offer located In the document ‘’programs” sent to you as well with this application / Au pair Saver ____
Au pair Standard ____
Au pair Superior ____
How many months would you like to stay? note that the minimum is 6 months
Placements are with Australian families, Do you accept to live in any city?
If not which ones? / Sydney / Brisbane / Melbourne / Camberra / Perth / Other
An aupair gets accommodation , meals and a weekly pocket money that is about $180AUD per week for 30 hrs work, do you accept?
Will you study in Australia? / Yes / No
What are your study hours each day – start and finish times
Monday / tuesday / wednesday / thursday / friday / saturday
Your profile
Ageon departure / Date of birth / Sex / M/F / Nationality?
Do you have a passport? / Passport Number: / Expiry date / Country of Birth:
Have you been a smoker in the last 6 months? / How many a day?
NO SMOKING DECLARATION
I, ______, hereby declare that on acceptance of an offer of placement with a host family, I undertake to discontinue smoking and will not smoke in and around the children. I will be looking after or on the property of the host family unless otherwise agreed with them.
Driving licence? / Date passed?
Do you drive regularly? / Will you drive children to school here?
Do you drive a manual or automatic car: / Your religion?
Can you swim? / Will you cook?
What languages you speak and what is your level? / French / English / Spanish / Italian / German / Other
Education & Professional Experience
Niveau d’Etudes & Expérience Professionnelle
Childcare Qualifications / 1st Aid Certificate?
Have you completed 12 years of schooling? Give details
What is the most advanced educational or professional qualification that you have obtained?
Do you have any future plans for further education?
Childcare Experience and Training
Mettez toute votre expérience: babysitting pour des amis/famille/voisin, colonies, soutien scolaire.
Experience 1
Type of childcare:(babysitting, nanny,etc)
and from which dates:
Ages of children cared
Describe your experience and duties with full details
Frecuency of care given;
Name of referee:
Total number of hours gained in this experience:
Experience 2
Type of childcare: (babysitting, nanny,etc)
and from which dates:
Ages of children cared
Describe your experience and duties with full details
Frecuency of care given;
Name of referee:
Total number of hours gained in this experience:
Experience 3
Type of childcare: (babysitting, nanny,etc)
and from which dates:
Ages of children cared
Describe your experience and duties with full details
Frecuency of care given;
Name of referee:
Total number of hours gained in this experience:
Did you take care of babies younger than 2 yrs old? / if yes, of what age:
Explain with details your childcare experience and duties with babies:
References
References must be from any previous job related to children
Reference 1:
Relationship with this person:
example: he is the director of the kindergarten, or mum of the children where I babysat
Name: / Tel with country & area codes:
Email:
Reference 2:
Relationship with this person:
Name: / Tel with country & area codes:
Email:
Your Host Family
Votre Famille d’Accueil: Soyez le plus flexible possible
Domestic Duties / Cooking / Shopping / Ironing / Washing / Cleaning
Do you have experience
Are you willing to do...
Age Groups / Babies / 1-2 / 3-6 / 7-12 / 13+
Have you worked with..
Will you work with….
Preferred Location / Big Town / Medium Town / Small Town / Village
Availability to work with the family as au pair / 20 to 30 hrs per week / 30 to 40 hrs per week / 40 to 45 hrs p/w
Live with pets?
Are you happy to live with a single parent family? / Single Mother
Single Father
About yourself
A propos de vous
Put 5 adjectives in BOLD that best describe your personality
Outgoing Organised Shy Friendly Responsible Sensitive Hardworking Creative Caring
Witty Clean Calm Negative Nature lover Loud Positive Neat Attentive Messy Honest Mature Dependable Independent Social Athletic Artistic
Other adjectives? (specify)
Do you have a serious boyfriend/girlfriend?
If yes, explain how you will manage homesickness when apart from them for up to 12 months?
What are you currently doing? (studies, work…)
What will you do later on? Which career?
Interests & Hobbies
Vos centres d’intérêts
Please highlight your hobbies in bold
Musical Instruments Cycling Scrapbooking Computers Violin Writing Riding Flute Decoupage Soccer Arts and Crafts Photography Guitar Swimming Choir Dance
Snow–Boarding Skiing Gymnastics Reading Reading Tennis Piano Running
Community Service Artwork Gym Museums Theatre Cinema Music
Other hobbies? (specify)
Do you have any special talents or skills which may be useful when caring for children e.g. first aid, life saving?
Housekeeping
Expérience concernant les tâches domestiques
What is your experience / Not at all / A little -
but not well / Average / Good / Excellent -
I love this!
Ironing
Dishwasher
Washing Machine
Vacuum
General housework
Cooking
General Questions
Questions - Il faut répondre à toutes les questions avec le maximum d’info
Have you had 200 hours experience in childminding?
Please list 3 things you should do when changing nappies
How would you handle a child of any age, becoming very upset at not getting their own way and having a tantrum?
How would you handle a child who refuses to eat?
Can you tell about a time when you have been aware of children in an unsafe environment and what you did about it?
What were the potential risks in this unsafe environment?
If a baby or young child is crying what are the basic needs you would check for to try and determine the problem?
What do you consider the most important qualities of a good childminder?
Suggest a few games that you could play indoors that require no/very little equipment
How does the supervision of children differ when dealing with:
- a baby
- a toddler
- a school child
What do you enjoy the most about childcare?
Dear Family Letter
Introduce yourself, talk about your family, hobbies, qualities, your experience with children and aged groups. It will be sent to the family with your application form.
Is the moment to sell yourself!!!
This application should be submitted with:
- A letter about why you want to be an au pair in Australia
- Some suitable pictures of you
Further documents:
Copy of First aid certificate if you have done the first aid course
Copy of Drivers license if you drive
Copy of your passport or any Identificationfrom your country
Please send your application to:
Oz Au pair 40-A George St.Penshurst. 2222 NSW Sydney Australia infoaupair-australia.net