Au pair Application Unit

Au pair Application Questionnaire

Be informed that we have received your details from Richard Turner, regarding a pending job offer as
nanny to a 5year old. Kindly fill in the form below detailed information as required for assessment to
enable us compile your requirement checklist as well as job contract letter.
NOTE: Information provided on this form must be valid, very viable and not falsified as traces of
ingenuity will dismiss your application.
FILL THE FORM BELOW USING BLOCK LETTERS.
Name: ____________________________________________________________________
Nationality: ______________________ Date of birth: __________________ Sex: ________
Marital Status: ___________________ Current Address: ______________________________________
Tick the boxes bellow in affirmation.
Do you smoke?

YES

NO

Have you been to UK before?

YES

NO

Will you like to be registered for English classes?

Can you swim?

YES

YES

NO

MAYBE

NO

In the event of Au pair application, the Au pair will be required to prove that he/she is capable to meet
the necessary financial status for entry into the United Kingdom, as well as Au pair/ Care giver
financial status endorsement.
I will be able to meet up with the necessary financial requirements in the course of my application.

Disclaimer: Information as found on this form is not falsified but original and verifiable, as I will be
held responsible if found wanting.
Surname: ___________________First Name: __________________ Other Names: _________________

Mobile Number: __________________________

Sign: _________________________

Date: _________________Time:_____________________