Family registration form

Au Pair / nanny registration for placement in Australia Before you fill in this FREE registration with AU-PAIR AUSTRALIA please make sure;

  1. You are eligible for a Visa. Read more
  2. You meet our "minimum requirements". Read more
  3. You are foreign, we only place Foreign Au Pairs into Australia. Read more

If you do not comply your application will be automatically rejected. Applicants that meet our requirements will get a confirmation response with in 72 hours.

About you
First name
Last name
Email
Confirm email
Nationality
Languages spoken
Gender
Male
Female
 
Age
Marital status

Address
Street address
City
State/Province
Postcode
Country
Contact Phone no
Emergency no
(Home Country)
Best time to reach you?

Au-Pair/Nanny Position Information

Our minimum placement is 4 months, Can you commit to this?
Yes
No
Will you study in Australia?
Yes No
Name of institution
Which City?
What are your study hours?  
 
Monday
Tueday
Wednesday
Thursday
Friday
Saturday
Sunday
What months?
Do you have visa Yes No
If yes, what type of visa?
Visa Number
Where would you like to work?

*capital cities are Sydney region, Melbourne region, Brisbane region,
If other - Please specify where?
Date available to begin work?
How long do you intend to stay in Australia? (Including travels)
How long do you intend to work as an Au-Pair?
Date of birth
Height (metric)
Weight (metric)
Health? Excellent  
Good
  Fair  
Poor
Do you you smoke? Yes No  
If yes how many per day?
Do you mind being placed with a family where someone smokes? Yes No    
Do you take any prescription medication on a regular basis?
*excluding contraception 		Yes No    
If yes, please name medication/s and describe condition it treats?
Any allergies? Yes No    
If yes - Please specify?
Have you ever suffered from an eating disorder? Yes No      
Have you ever been treated for physiological trouble? Yes No      
Do you eat most things? Yes No      
Do you eat meat? Yes No      
Do you eat Fish? Yes No      
Do you play an instument? Yes No      
What are your hobbies or interests?
Do you have a driver license? Yes No

* if you do have a licence but don’t want to drive in Australia tick in No
Do you drive a manual? Yes No      
How long have you had your driver’s licence?
How often do you drive?
Describe any accidents that may appear on your driver’s licence record
Do you have a first aid certificate or similar? Yes No      
How good are your English language skills
(5 is fluent)
5 4 3 2 1
How long is the longest time you have been away from your family?
Who are you living with right now?
How many children are there in your family?
Which number in the line of children are you?
What is your current occupation?
What are your career plans after you return to your home country?
Are you religious? No Yes    
Do you have any religious needs?
Are you willing to be placed with a family that has a different denomination to your own? No Yes    
Do you have a police record No Yes    
How did you hear about our agency?
About the job
Please select yes, no or maybe to the duties you would be willing to undertake.
Childcare for working parents?
 
Childcare for stay at home parents?  
Childcare for single parents?  
Cooking for children?  
Housekeeping related to child's care?  
Occasional cooking for entire family?  
Housekeeping for family?  
Are you willing to do light cleaning?  
Are you willing to look after common pets? e.g dogs, cats, fish  
What ages of children do you prefer?

* The most common family profile in Australia is 3 children under 5, your changes of placement will increase significantly if you are willing to look after young children

Please describe your childcare experience giving dates, duties and age of children cared for
Any other comments you think would be helpful to us
How can we improve our site?
The information I have entered is true and correct.  
Name
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