Au-Pair Registration

Firstnames (as in passport)

Last name (as in passport)

Gender

Date of birth

Place of birth

Nationality

Address

Email Address

Password
(choose 8 digit password)

Password confirmation

Phone number

Emergency contact number:

Skype name

Height in cm

Weight in kg

Are you in good health?

When are you available to start?

Period of stay

Matching / Self Match

Which agent do you go through?

Preference age of children: (from/till how many years old)

Are you willing to take care of a baby?

Max amount of children

Religion

Interests and sports

Do you smoke?

Do you have tattoos?
(if yes, please specify)

Do you have piercings?
(if yes, please specify)

What kind of education did you have and for how many years?

What kind of experience with child care do you have and for how many years?

Can you provide us with childcare references?

Did you work as an au-pair before?

Do you know how to swim?

Do you have a drivers license?

Do you speak English?

Do you have a criminal record?

Agree to pay NEDSA Au Pair Nederland the legal maximum amount of € 34,- as registration fee and confirm to agree to the general term and conditions.

* I hereby accept the terms and conditions for the Au Pair program