Family Registration Form

Please complete this form to register as a family seeking an Au Pair.
Registration is free, we simply need a few details about you and your
family.

When you have completed this form we will match you to an Au Pair that best
suits you.
Personal details will be kept strictly confidential.

*Items marked with a hash (#) must be completed.

Your Details
Full Name	#
Address
Street	#
Suburb	#
Post Code	#
E-Mail Address
Home Phone Number
Work Phone Number
Mobile Phone Number
Fax Number
What country do you live in?	#
Some details for the Au Pair to know
How many adults in the family?	#
How many children in the family?	#
How many boys and what age?
How many girls and what age?
Do you have any pets?	#
Does your Au Pair need to hold a drivers licence?	#
Would you prefer a non-smoker?	#
Do you have a preferred nationality?
What wage can the Au Pair expect per week?	#
Final Details
When would you like your Au Pair to commence work?	#
How long would you like the Au Pair for?	#
Is there anything else you would like the AuPair to know?