Au Pair Application Form - Alliance Visas

Where do you live? *

Where do you want to go? *

Enter your first and last name *

What is your Nationality? *

How old are you? *

What is your email address? *

Please re-enter your email address *

What is your Mobile number? *

What is your marital status?

What is your total work experience?

Please state the field of work and number of years/ hours in each?

What is your highest qualification?

How would you rate your English speaking skills?

Do you know any other language apart from English?

Have you ever committed, been arrested for, been charged with, or convicted of any criminal offence in any country/territory? *

Yes

No

Do you have previous documented childcare experience?

Yes

No

Do you have any additional diplomas or certificates from any online courses?

Yes

No

Do you have a valid driver’s license?

Yes

No

Are you a smoker?

Yes

No

Do you have any physical or mental disorder that would require social and/or health services, or regular medication?

Yes

No

Have you ever been refused a visa or permit, denied entry to, or ordered to leave from any country/territory?

Yes

No

Have you worked in any other country other than your country of residence?

Yes

No

Have you ever participated in the AU pair program before?

Yes

No

Would you be able to provide more than one reference from employers and personal (neighbor/friend/colleague) reference?

Yes

No

Do you know how to cook for yourself if needed?

Yes

No

Please give details of what did you do when you baby sat a kid in your last job?

How soon can you travel or join work?

Would you be able to provide a video of you with your family showing your life for the host family along with pictures of you taking care of a child?

Yes

No

Would you be open to pursuing further studies for your coursework requirement in USA?

Yes

No