Name

Last Name

Telephone Number

Email Address

Street Address

Street Address (Line 2)

City

State / Province

Postal / Zip Code

ID Number

Languages spoken Languages spoken English Afrikaans Sesotho Zulu Other

Please spesify what other languages

Dependants

Religious views

Hobbies

Do you have First Aid? Do you have First Aid? *YesNo

Please specify level and expiry date

Do you have a driver's license? Do you have a driver's license? *YesNo

When did you start driving?

Do you have your own reliable transport? Please specify (Eg. Chev Spark 2014)

Field of study and graduation year (Eg. Foundation Fase 2021)

What is your highest level of education?

Relevant experience (Eg. babysitting, tutoring - please give as much detail as possible; time worked with family, age of children, etc.)

References

Why would you be a good au pair? (This will be added to your portfolio for the family to see, tell us a bit about yourself.)

From what date are you available?

Please upload a shoulder length photo of yourself Please upload a shoulder length photo of yourself File InputChoose FilesNo Files ChosenAccepted file types: jpg, jpeg, jpe, png. Max. file size: 3 MB

Have you read and agree to the below information? Have you read and agree to the below information? Yes