Proprietor: Mrs S.Singh
                                                                                                                                                  
                                                                                                                                         Arrangements by telephone and post only
                                                                                                                                         Office hours:
                                                                                                                                          Mon. 09.30 – 15.00
                                                                                                                                          Tues. Thurs. Fri. 09.30 – 12.30
                                                                                                                                          Wed. 19.00 – 21.00

APPLICATION FOR AN AU PAIR POSITION IN ENGLAND                                                                                                                 
( Please complete in BLOCK CAPITALS )

SURNAME AND CHRISTIAN NAME: ......................................................................................................

TEL:NO:.................................................................FAX NO:.........................................................................

ADDRESS:.............................................................................................NATIONALITY:............................

RELIGION:..............................MARITAL STATUS:.................HEIGHT...................WEIGHT.................

DATE OF BIRTH:..............................FATHER´S PROFESSION:...............................................................

MOTHER´S PROFESSION:.......................................PARENTS´OR NEXT OF KIN´S ADDRESS:.........

.....................................................................................................................TEL.NO:.....................................

AGES OF BROTHER´S:...........................................AGES OF SISTERS:...................................................

EDUCATION AND QUALIFICATIONS ( Please give details of schools, colleges, university attended and subjects studied ):
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EMPLOYMENT AND QUALIFICATIONS ( Please describe briefly your present job and give details of previous jobs you have had, part time and full-time, including weekend and holiday jobs ):

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WHAT  KNOWLEDGE HAVE YOU GOT OF ENGLISH?  fluent / good / fair / a little / none
How many years have you studied English?............................................................

OTHER FOREIGN LANGUAGES SPOKEN:....................................NO.OF YEARS STUDIED...............

DO YOU WISH TO ATTEND LANGUAGE CLASSES?..................................

HAVE YOU BEEN AN AU PAIR BEFORE?..........................................IF SO, WHERE?.........................

........................................................................................................................................................................

PLEASE GIVE FULL INFORMATION OF CHILD CARE EXPERIENCE AND QUALIFICATIONS:.

PLEASE GIVE FULL INFORMATION OF CHILD CARE EXPERIENCE AND QUALIFICATIONS:

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DO YOU HAVE EXPERIENCE WITH BABIES?........TODDLERS?........CHILDREN OF SCHOOL  AGE?.......................................................................

WHICH AGE GROUP DO YOU PREFER?....................HOW MANY?...........DO YOU LIKE CHILDREN?...........................................................

WOULD YOU ACCEPT A POSITION WITHOUT CHILDREN?...............................................................

A SINGLE PARENT FAMILY?..............................................................

CAN YOU COOK,IRON,SEW,MEND?..........................DO YOU HELP AT HOME WITH 

HOUSEWORK? ..................ARE YOU IN GOOD HEALTH?.............DO YOU HAVE ANY 

ALLERGIES?...................................

ARE YOU SUFFERING FROM ANY MEDICAL CONDITION THAT COULD AFFECT YOUR 

WORK AS AN AU PAIR? ( If so, please specify )................................................................................................................

ARE YOU A VEGETARIAN?.............................IF SO, WHAT DO YOU EAT? .......................................

............................ DO YOU SMOKE?...........IF SO, HOW MANY CIGARETTES A DAY?.....................

WOULD YOU AGREE NOT TO SMOKE IN THE  FAMILY´S  HOME?........................WHAT ARE 

YOUR INTERESTS AND HOBBIES?.........................................................................................................

DO YOU DRIVE?.....................WHAT  DATE  DID YOU PASS YOUR DRIVING TEST?......................

WILL YOU DRIVE IN ENGLAND?..............DO YOU SWIM?..............DO YOU LIKE PETS?...............
( See our notes on driving )

WHAT AREA DO YOU PREFER? city...................small town...............country....................anywhere...........................

WHEN CAN YOU START WORK AS AN AU PAIR?.............HOW LONG CAN YOU STAY?.............

DO YOU HAVE A VALID PASSPORT?......................................

PLEASE GIVE ANY FURTHER INFORMATION WHICH ENABLE ME TO PLACE YOU IN THE 
RIGHT FAMILY:
..........................................................................................................................................................................

HOW DID YOU HEAR OF THIS AGENCY?...................ARE YOU REGISTERED WITH ANOTHER AGENCY?........................................................

I confirm that the information given above is true and correct and that I have read and understood the terms and conditions of Metro Agency and  its notes on “ Au  Pair in England “ and I agree to the said conditions.

Name...................................................................                                Date.....................................................