about you: |
| salutation: |
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| last name(s): * |
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| first name: * |
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| street: |
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| zip/postal code: |
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| city: |
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| country: |
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| phone: * |
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| mobile/cell phone: |
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| e-mail: * |
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| nationality: |
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place of birth: |
| country: |
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| date of birth: (dd.mm.yyyy) |
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travel details: |
| where do you want to go? * |
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| do you have a current, valid passport? |
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| have you applied for a visa? |
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| if yes, which type of visa? |
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| when can you start? * |
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| how long can you stay? * |
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host family & surroundings |
| preferred position with host family: |
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| children’s ages: |
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| number of children: |
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| can you cook? |
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| will you cook for children? |
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| will you cook meat for children? |
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| will you do light housework? |
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employment history |
| please describe your experience in child care and list your formal child care qualifications, if any: |
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| how old were the children you cared for? |
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| what is your most recent occupation? |
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| detail your employment history: |
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| do you have written references? |
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| what are your hobbies and interests? |
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language skills |
| how good is your english? |
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| what other languages do you speak? |
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| are you planning to attend language classes? |
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driving |
| do you hold a valid driving licence? |
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| do you hold a valid international driving licence? |
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| are you able to drive a manual transmission? |
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| are you able to drive an automatic transmission? |
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| have you had any accidents? |
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| if yes, list the date of all accidents, describe what happened, and give details of any disqualification: |
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personal information |
| what is your religion? please describe any religious needs: |
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| do you suffer from any illnesses or allergies? |
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| if yes, please elaborate: |
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| do you use any medication regularly? |
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| if yes, please elaborate: |
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| do you follow any special diet? |
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| if yes, please elaborate: |
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| do you smoke? |
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| do you drink alcohol? |
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| please indicate if you have any of the following: |
multiple earrings
nose stud
nose ring
tongue stud
eyebrow stud
visible tattoo
dreadlocks
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application |
| preferred contact method: |
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| do you consent to your application profile and photograph being forwarded to prospective host families? |
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