Gen 122 Services

New Candidate Application Form for AuPair Vacancy

First Name:

Surname:

Gender:

Male Female

Marital Status:

Married Single Other

Mobile Number:

Current Address:

Email Address:

Do you have a criminal record?:

Yes No

Country of Residence:

Date of Birth:

Nationality:

Current Occupation:

Religion:

Languages Spoken :

Child Care Qualifications:

Do you have any Child care experience?:

Yes No

If yes how many Years? :

Name of Last Employer :

Address of Last Employer :

How many children did you care for?

How old were the children? :

Why did you stop working there? :

Please give reasons why you are applying for work as an Au Pair; Give as much information as you can:

Do you have any health problems or disabilities? :

Yes No

Please give detatils:

Do you smoke? :

Yes No

Can you drive? :

Yes No

How long have you been driving for in the UK? :

Are you willing to drive for your host family? :

Yes No

Can you Swim :

Yes No

Do you like animals :

Yes No

Do you have References? :

Yes No

What are your hobbies and interests?:

What type of job are you looking for?

Live In Aupair Live Out Aupair

Au Pair Plus Mother's Help

Earliest Start date available:

Minimum length of stay(months):

Latest Start date available:

Maximum length of stay(months):

Do you want to attend English Classes ?:

Yes No

Are you willing to help with:

Baby Sitting Housework

Cooking Ironing/Laundry

Would you work for a :

Single Mother Family with different religion

Single Father Family without children

Would you care for :

An Elderly person A disabled person

Days You are Available To Work :

Monday	AM	PM
Tuesday	AM	PM
Wednesday	AM	PM
Thursday	AM	PM
Friday	AM	PM
Saturday	AM	PM
Sunday	AM	PM

What locations will you prefer to work?:

Expected Rate of Pay per week?:

How Did You Hear About Us?:

I have read the Agency's terms and condition and by submitting this form I agree to this terms and conditions.

Current Jobs

Au Pair Needed in Chafford Hundred

There is currently a requirement for an Au Pair for one of our families in based in