Kidz Au Pair Agency

Registration form for Au Pairs from other countries.

Au Pair Registration Form By Post

If you prefer you can Download and Print out the form, please send completed forms to:

Kidz Au Pair Ltd.,
Passage West,
Cork, Ireland.

Au Pair Registration Form By Fax

Fax to +353-21-4841905.

Also we ask you to enclose two passport size photographs with application.

Download PDF form now

Step 1 of 2 : On-Line Au Pair Application

Name

Surname

Address

Which country are you from?

(EU Applicants Only)

Nationality

Telephone Number

Mobile Number

Email Address

Religion

Gender

Age

Marital Status

Current Occupation

Mothers Occupation

Fathers Occupation

Hobbies and interests

What languages do you speak?

Do you speak the English language

Little Conversational Fluent

What Education & Qualifications do you have?

What Jobs have you had

Are you currently employed:

Student:

Will you be attending Language Classes:

Start Date

Length of stay

months

Are you in good Health

Are you Allergic to anything

If yes give Details?

Have you any medical condition

If yes give Details

Do you smoke

Will you smoke only outside the Family house

Are you a Vegetarian.

Do you drive:

How Long?

Will you drive as an Au pair

Can you Cook simple meals

Have you worked as an Au pair before

If yes give Details

Do you have experience in taking care of Children

If yes give Details

What ages of Children are you happy to work with:

0-3 3-5 Any Age

Would you work with Children with a disability

Are you Happy to do light House work

Do you like Animals

Do you want to live in

Will you accept a single Parent Family with no Mother

Have you ever been convicted of any criminal offence

Any information/Hobbies you would like to tell the Family about yourself:

Where did you hear abou t us?

By checking this tick box, I / We accept and agree to abide by the Kidz au pair agency terms and conditions of business. (July 2007). Whic I / we have read and understood. I / we confirm that the information provided in our application form is correct and accurate. I / we shall also notify Kidz Au Pair immediately if there are changes to the information in our application form