FAMILY
REGISTRATION
  

 
Type of Au Pair required? Au Pair Mothers Help Au Pair plus
Family Name
First Name(s)
Address
Town
County
Post Code
Nationality
Your Religion
Home Phone
Mobile Phone
Fax
Email Address
Details of Children
What will be the Au Pair's duties?
How much are you prepared
to pay the Au Pair?
Au Pair can smoke? Don't Mind No Not in house
Au Pair to drive? Yes No Doesn't matter
Preferred Gender? Female Male Either
Preferred start date
Length of stay
Further information or
message to Au Pair?