Atlantis Exchange
Au Pair Host Family Profile 2017
This form is for the potential au pair to get to know you better when you are in the process of choosing a candidate. Remember to attach pictures of the au pair’s room and feel free to add a personal letter if you want to. This profile has to be filled out by all families considering contacting an au pair through Atlantis Exchange.
Personal info
Host #1: Nationality: Year of birth:
Occupation: Mobile Phone: E-mail:
Host #2: Nationality: Year of birth:
Occupation: Mobile Phone: E-mail:
Location
Complete address:
Nearest city/town:Nearest airport: Nearest train station:
Describe the area:
The family
Children’s name and year of birth:
Children spending the day at home (names):
Children in kindergarten:
Children in school:
Are your children living with you full-time or part-time?
Will the au pair's duties include nursing the host family's children with special needs: Yes☐ No☐
If yes, please elaborate:
Have you had au pair before? Yes☐ No ☐ / Through Atlantis Exchange: Yes☐ No☐
Do you have any pets? Yes☐ No ☐ If yes, please elaborate:
Other comments/information:
Cultural exchange
1.Which hobbies do the family have?
2. Which activities would you like the au pair to take part in?
3. Will you offer the au pair to come with you on a holiday? Yes ☐ No ☐
If yes, when and where?
4. How can you contribute to the cultural exchange?
5. What do you expect from the au pair when it comes to cultural exchange?
The au pair
From when do you wish to invite an au pair:
For how long do you want the au pair to live with your family:
2-6months ☐ 6 months☐ 10 months☐ 12 months☐
Comments:
Driver’s License: Yes ☐ No ☐ Only for his/her own sake ☐
We would like to invite a: Maleau pair☐Femaleau pair☐ Gender not important☐
Schedule
Days off per week for the au pair:
Weekly work schedule for the au pair
The weekly work schedule gives the au pair an impression of what a regular week as your family’s au pair will look like.Please note that each square means one hour, and you are only supposed to fill in where the au pair is on duty (maximum 5 hours per day/ 30 hours per week). It is also considered working hours for the au pair when the children are sleeping if he/she is watching them.Night work must not be part of the au pair’s regular duties.
Please specify the different working tasks within each square. The main purpose of the au pair programme is cultural exchange, which means that social interaction with the children and the family is a central aspect. A maximum of 15 hours weekly can be reserved for household chores.
Monday / Tuesday / Wednesday / Thursday / Friday / Saturday / Sunday07.00
a.m.
08.00
a.m.
09.00
a.m.
10.00
a.m.
11.00
a.m.
12.00
a.m.
01.00
p.m.
02.00
p.m.
03.00
p.m.
04.00
p.m.
05.00
p.m.
06.00
p.m.
07.00
p.m.
after
07.00
p.m.
Childcare / Often / Sometimes / Never
Playing games
Going for walks
Reading aloud
Waking up/bringing to bed
Bring/pick up the children to/from school
Changing diapers
Feeding
Dressing
Bathing
Light housework / Often / Sometimes / Never
Vacuuming
Ironing
Dusting
Tidying up after children
Grocery shopping
Cooking
Help with the cooking
Washing the dishes
Doing laundry for the children
Cleaning the children’s rooms
Looking after pets
Taking care of plants
The profile must includepictures of:
(i)the au pair room, (ii) the bathroom the au pair willhave to his/her disposal.
It is also nice for the au pair if you include a few pictures of the family.
*Insert pictures directly into this document.
Atlantis Utveksling / Atlantis Exchange
Samtykke
Jeg samtykker herved til at alle de ovenfor gitte opplysninger registreres og lagres hos Atlantis Utveksling så lenge som er nødvendig for formålet, og at disse opplysningene videresendes til de au pairene jeg er i kontakt med samt til Atlantis Utvekslings lokale utenlandske samarbeidspartnere i de aktuelle kandidatenes hjemland.
Jeg kan når som helst kreve at denne familieprofilen slettes hos Atlantis Utveksling, så lenge jeg ikke lenger har en au pair gjennom Atlantis Utveksling. Dette skal skje ved skriftlig henvendelse til Atlantis Utveksling. Jeg er innforstått med at Atlantis Utveksling vil kreve ny familieprofil før jeg igjen kan invitere en au pair.
Jeg erklærer herved at alle de ovenfor gitte opplysninger er korrekte og oppgitt frivillig til Atlantis Utveksling.
Sted og dato:
______
Signatur:
______
Vennligst signer og send skjemaet til Atlantis Utveksling, enten på e-post eller per post til Atlantis Utveksling, Skippergata 9, 0152 Oslo.