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Become an Au Pair Questionnaire
First & Last Name
*
(Nombre)
Email Address
*
Phone Number
*
Postal Address
*
Skype ID
Country Desired (País deseado)
*
Ireland
England
Spain
USA
Date Of Birth
*
Passport No
*
Do you hold a driving license? (¿Tienes permiso de conducir?)
Yes
No
How long are you driving
*
Have you driven with children under your care?
*
How many times a week do you drive
*
Will you drive in the host country?
*
Height (cm)
*
Weight (kgs)
*
Nationality
*
ID Number
*
Spoken English level
*
Written English level
*
Where were you born?
*
Occupation
*
Previous Occupation
*
Future Career Plans?
*
Next of Kin
*
Name and contact number of next of kin
*
Have you any special diet requirements?
*
Have you worked with new-borns?
*
What ages have the children you have experience with
*
(¿En qué trabajos tienes experiencia?)
0-6 months
6-12 months
1-3 years
3-5 years
5-10 years
What jobs have you experience in?
*
(¿En qué trabajos tienes experiencia?)
Changing Diapers
Bathing
Feeding
Cooking
Making Breakfast
Laundry
Children’s Laundry
Putting children to bed
Overnight Babysitting
Have you looked after children with learning difficulties?
(¿Has cuidado de niños con dificultades de aprendizaje?)
Yes
No
Would you look after children with learning difficulties
(¿Cuidarías de niños con dificultades de aprendizaje?)
Yes
No
Have you any experience in working with handicapped children
(¿Tienes experincia en trabajar con niños discapacitados?)
Yes
No
Have you worked with seniors?
(¿Has trabajado con personas mayores?)
Yes
No
How many children are you willing to look after?
*
What ages would you prefer?
*
(¿Qué edades prefieres?)
0-6 months
6-12 months
1-3 years
3-5 years
5-10 years
What is your level of cooking?
*
(Nivel de habilidad de cocinar)
Average
Good
Very Good
Excellent
Have you changed diapers before?
(¿Has cambiado pañales antes?)
Yes
No
If yes, please, tell us more about your experience with babies
*
List other skills/experience you have in childminding
*
Have you been away from home before?
(¿Has estado fuera de casa antes?)
Yes
No
Professions of Parents
*
Education (must provide proof)
*
Experience (must provide references)
*
If so, which ones
Preferred City/Town
*
Any medical conditions
*
Can you speak any other language?
*
Requested start date
*
Length of placement
*
Would you accept a family that smokes?
(¿Aceptarías a una familia que fuma?)
Yes
No
Do you smoke?
(¿Fumas?)
Yes
No
Occasionally
Do you like animals?
(¿Te gustan los animales domésticos?)
Yes
No
Interests/ Hobbies
*
What expectations do you have of the Au Pair placement
*
Would you do additional chores if needed?
(¿Harías tareas adicionales si fuera necesario?)eco
Yes
No
Why do you want to be an Au Pair in Ireland?
*
Something about yourself
*
We also need additional documents such as copy of passport, heath check, 5 - 6 photos, criminal record check, childcare references and photographs within 48 hours of completing this form.
Have you been in contact or had COVID19 in the past?
Yes
No
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