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Contact details

Name *

First name *

E-mail *

Mobile

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Family composition

Number of children *

Boy(s)

Girl(s)

Age *

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Your future au pair

Driving licence required? *

Yes

No

Preference for a specific nationality? *

Yes

No

If so, which nationality?

Preference for a specific language? *

Yes

No

If so, which language?

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Tasks

Babysitting *

Choose an option

• Yes
• No
• Sometimes

Babysitting during the weekend *

Choose an option

• Yes
• No
• Sometimes

Babysitting during the evening *

Choose an option

• Yes
• No
• Sometimes

Assistance with homework *

Choose an option

• Yes
• No
• Sometimes

Driving the children to activities / school *

Choose an option

• Yes
• No
• Sometimes

Cooking a simple meal *

Choose an option

• Yes
• No
• Sometimes

Bathing children *

Choose an option

• Yes
• No
• Sometimes

Feeding a baby *

Choose an option

• Yes
• No
• Sometimes

Making the beds *

Choose an option

• Yes
• No
• Sometimes

Ironing *

Choose an option

• Yes
• No
• Sometimes

Empty the dishwasher *

Choose an option

• Yes
• No
• Sometimes

Shopping for food *

Choose an option

• Yes
• No
• Sometimes

Cleaning the kitchen *

Choose an option

• Yes
• No
• Sometimes

Taking the dog for walk *

Choose an option

• Yes
• No
• Sometimes

Others?

Tidy up *

Choose an option

• Yes
• No
• Sometimes

Additional comments (house rules, expectations, special skills, etc.)

We declare that the information provided in this application form is true and correct. Any incorrect or false answers may result in the cancellation of the registration. We will comply with the legal provisions concerning au pairs in Belgium *

Yes, the information provided in this application form is true and correct.

Submit

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