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Families Registration
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Families Registration
Step 1 of 6 - Personal Information
16%
Quick Registration (Complete in English)
Name
*
First name
Surname
Would you consider any nationality:
*
Yes
No
If not, specify:
*
Approx. start date for the Au pair:
*
Duration of Stay (Months):
*
1 month
2 months
3 months
4 - 6 months
6 - 9 months
9 - 12 months
Identity Card / Passport Number
*
Address
*
Street Address
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Phone Home (with code):
*
Email:
*
Skype/Email
*
Facebook:
What languages family speak at home:
*
Mother's Information
Mother's First Name
Mother's Age
Mother's Occupation:
Mother's Mobile (with code):
Mother's Religion:
Do you practice it:
Yes
No
Father's Information
Father's First Name
Father's Age
Father's Ocupation:
Father's Mobile (with code):
Father's Religion:
Do you practice it:
Yes
No
CHILDREN'S INFORMATION
Number of children
0
1
2
3
4
5
6
7
Name
Age
Name
Age
Name
Age
Name
Age
Name
Age
Name
Age
Name
Age
Is a baby expected:
*
Yes
No
Are you a single parent:
*
Yes
No
Quick Registration (Complete in English)
Age preference
18 - 20
21 - 23
24 - 26
27 - 30
30 +
Don't mind
Is a non smoker essential:
*
Yes
No
If not, where is he/she allowed to smoke:
*
Is a car driver essential:
*
Yes
No
If yes, is a car provided?:
*
Yes
No
Would you consider a male au pair:
*
Yes
No
Is a swimmer essential:
*
Yes
No
Quick Registration (Complete in English)
Do you live in the
*
City Center
Town
Villege
Country
What includes the Au pair bedroom:
TV
Desk
Chair
Shelves
Toilet
Towels
Bed linen
Wifi at home
Closet/Wardrobe
How many bedrooms in your home:
*
How many bathrooms in your home:
*
How many separate toilets in your home:
*
Do you have any pets?:
*
Yes
No
If yes, specify:
*
Special interest or hobbies of your family, if any:
*
Do you have any domestic help? (Cleaner, gardener...):
*
Yes
No
Quick Registration (Complete in English)
Which days the Au pair will work
Monday
Tuesday
Wednesday
Thursday
Friday
According to the European Agreement of Au pair Placement, the Au pair must have at least one day an a half free and one full day will be Sunday.
Working hours per day / Pocket money
*
15 hrs a week / 70€ per week
20 hrs a week / 80€ per week
25 hrs a week / 90€ per week
30 hrs a week /100€ per week
Plus two nights of baby-sitting.
If you requires the same hours but wants to pay more, write below.
*
Free Days:
*
Will the au pair required to do light housework?:
*
Yes
No
Will the au pair be required to cook for children?
*
Yes
No
Will the au pair be required to do ironing for children?:
*
Yes
No
Will the au pair be required to do babysit?
*
Yes
No
Quick Registration (Complete in English)
Cover Letter
*
Family letter presentation, why would you like to have an Au pair (at least 150 words).
Identity Card / Passport
*
Accepted file types: pdf, doc, docx, rtf, txt, jpg, gif, png.
Pictures
*
Drop files here or
How did you find about us?
*
Terms and conditions
READ ADAYSS CONTRACT
I have read and understand this agreement and I accept and agree to all of its terms and conditions.
*
I accept
Quick Registration (Complete in English)
If you are going to do online registration, at the end you will have to attach next documents:
Passport / Identity Card
Pictures (of family, house, Au pair's room...)
Already completed the form!
Go to payment
Payment Method
*
BANK TRANSFER
PAYPAL
BANK ACCOUNT DETAILS FOR PAYMENT
BANK ING
IBAN: ES96 1465 03 90111735151270
BIC-SWIFT: INGDESMMXXX
Address: Alameda Mazarredo, 7 CP 48009 Bilbao (Bizkaia) Spain
Please indicate in the Bank Transfer your full name.
Pre-registration Host family Program
*
Host Family Pre-Registration
Total
0,00 €
