Name

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Contact details

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E-mail address *

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Street and number *

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State / province / region

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Fax number

Private home page

Where do you live

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in a big city
in a small town
in the country

Country

U.S.A. AlbaniaAlgeriaArgentinaArmeniaAustraliaAustriaAzerbaijanBelarusBelgiumBosnia and HerzegovinaBrazilBulgariaCameroonCanadaChileChinaColombiaCosta RicaCôte d'IvoireCroatiaCzech RepublicDenmarkEcuadorEgyptEstoniaFinlandFranceGeorgiaGermanyGhanaGreeceGuatemalaHong KongHungaryIcelandIndiaIndonesiaIrelandIsraelItalyJapanKazakhstanKenyaKyrgyzstanLatviaLithuaniaLuxembourgMacedoniaMadagascarMalaysiaMexicoMoldovaMongoliaMontenegroMoroccoNamibiaNepalNetherlandsNew ZealandNigeriaNorwayother countryPeruPhilippinesPolandPortugalRomaniaRussiaSenegalSerbiaSingaporeSlovakiaSloveniaSouth AfricaSouth KoreaSpainSwedenSwitzerlandTaiwanThailandTogoTunisiaTurkeyUkraineUnited Arab EmiratesUnited KingdomUzbekistanVenezuelaVietnam

Your nationality

American AlbanianAlgerianArgentinianArmenianAustralianAustrianAzerbaijanianBelarusianBelgianBosnian HerzegovinianBrazilianBritishBulgarianCameroonianCanadianChileanChineseChinese/Hong KongColombianCosta RicanCroatianCzechDanishDutchEcuadorianEgyptianEstonianFilipinoFinnishFrenchGeorgianGermanGhanaianGreekGuatemalanHungarianIcelandicIndianIndonesianIrishIsraeliItalianIvoirianJapaneseKazakhKenyanKoreanKyrgyzLatvianLithuanianLuxembourgishMacedonianMadagascanMalayanMexicanMoldovanMongolianMontenegrinMoroccanNamibianNepaleseNew ZealanderNigerianNorwegianother nationalityPeruvianPolishPortugueseRomanianRussianSenegaleseSerbianSingaporeanSlovakSlovenianSouth AfricanSpanishSwedishSwissTaiwaneseThaiTogoleseTunisianTurkishUkrainianUnited Arab EmiratesUzbekVenezuelanVietnamese

Your family

How many children will the au pair need to look after

0123456789

Your au pair will need to care for children aged

012345678910111213141516171819202122232425262728293031323334353637383940414243444546474849  and 012345678910111213141516171819202122232425262728293031323334353637383940414243444546474849  years

Have you had an au pair before?

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Are you a single parent?

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Will the au pair need to care for disabled children?

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Do you smoke?

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