AU PAIR Application Form

AU PAIR Application Form

Personal Information
Full Name		Recent Photo
Date of Birth（DD/MM/YY）
Gender
Ethnicity
Religion
Nationality
Address	Country
Province/State
City
Postal Code
Mother Language
Chinese Level	N/A 0-300 Words 300-800 Words 800 Words
Other Language	Language 1 Basic Good Excellent
Language 2 Basic Good Excellent
Language 3 Basic Good Excellent
Program Information
Program Period
Earliest Arrival Date
Latest Arrival Date
Accepted the Numbers of kids
Family Information
Parents Info	Full Name	Position
Father
Mother
Siblings Info.
Education Background
Degree	School Name	Start Date	End Date	Major
Career Condition
Position Title	Reponsibility	Start Date	End Date	Remarks
Personal Interests/Hobbies/Skills
Interests/Hobbies
Sports
Music Instrument
Had any following diploma?	BabyTeacher Coach（eg. Sports） First Aid Lifeguard
Other Skills
Childcare Experience/Plan
Experience
Time Period	Responsibility	Age of the Kids	Hours per week	Remarks
Childcare Plan
How to assist the family to teach the kid?
What materials/reference do you use to teach the kid?
What activities will you plan to interact with the kids?
Health Condition
Do you have any pre-existing medical conditions or disabilities? If yes, please explain
Do you have any allergies?
Do you have any physical or medical restrictions? If yes, please list them
Do you take medications or drugs regularly? If yes, Please list medications and conditions being treated
Have you ever needed treatment, counseling or hospitalization for a psychological or psychiatric condition? If yes, please describe
Other Information
Do you have pets? Mind living with pets?
Do you smoke?
Have you ever been convicted of a felony or misdemeanor not including traffic violations?
Are you a vegetarian?
Do you have dietary restrictions? If so, please list them
Letter to the Host Family
Photos

Дата добавления: 2015-08-27