RICHMOND & TWICKENHAM AU-PAIRS & NANNIES
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REGISTRATION FORM
FAMILY DETAILS
SURNAME:
FIRST NAMES:
ADDRESS:
TEL. NO.
Daytime:
Evening:
Fax:
E-mail:
OCCUPATION:
Husband:
Wife:
HOURS OF WORK:
Husband:
Wife:
NATIONALITY:
Husband:
Wife:
RELIGION:
Husband:
Wife:
HOW MANY CHILDREN:
NAMES AND AGES OF CHILDREN:
IS A NEW BABY EXPECTED?
Yes
No
IF YES WHEN?
TYPE OF HOME:
NUMBER AND TYPE OF ROOMS:
Reception:
0
1
2
3
4
Bedrooms:
1
2
3
4
5
6
Bathrooms:
1
2
3
4
5
6
Toilets:
1
2
3
4
5
6
Other rooms:
Garden:
None
Small
Medium
Large
FAMILY PETS:
FAMILY INTERESTS:
SHOULD THE AU-PAIRS PARENTS REQUIRE A REFERENCE, PLEASE GIVE A NAME AND ADDRESS OF SOMEONE WHO HAS KNOWN YOU PERSONALLY FOR AT LEAST THE LAST 2 YEARS:
NAME:
ADDRESS:
HOW DID YOU HEAR ABOUT
RICHMOND & TWICKENHAM?
LOCATION DETAILS
RURAL
QUIET RESIDENTIAL
BUSY RESIDENTIAL
MAIN ROAD
HOW FAR IS /ARE THE NEAREST:
PUBLIC TRANSPORT:
TOWN:
SHOPS:
ENGLISH CLASSES:
PLACES OF INTERESTS:
AU-PAIR DETAILS
REQUIRED NUMBER OF MONTHS:
FROM:
TO:
DO YOU NEED A FEMALE AU-PAIR?
DON'T MIND
DEFINATELY
WANT A BOY
PREFERRED NATIONALITIES:
(Please leave blank if no preference)
DO YOU NEED AN AU-PAIR/AU-PAIR PLUS
CAR DRIVER
UNCONCERNED
PRERFERRED
ESSENTIAL
NON-SMOKER
UNCONCERNED
PRERFERRED
ESSENTIAL
WOULD YOU ACCEPT A SMOKER WHO IS HAPPY TO SMOKE OUTSIDE?
YES
NO
OTHER PREFERENCES (if any):
POCKET MONEY TO BE PAID:
FREE DAY/S:
WILL THE AU-PAIR BE TREATED AS A MEMBER OF THE FAMILY, JOINING YOU FOR MEALS AND ALSO IN THE EVENINGS ETC
AU-PAIRS ACCOMMODATION:
OWN TELEVISION
Yes
No
BICYCLE
Yes
No
CAR
Yes
No
TIMETABLE OF DUTIES
Please state how you would expect your au-pair to spend a typical day, remembering that she will not be expected to work for more than 5 hours a day and must be allowed time off during school hours to attend English classes.
RISE AT:
MORNING DUTIES:
LUNCH AT:
AFTERNOON DUTIES:
I have received, read and agree to your Accounts and Business terms.