Planet Au Pair
C/Los Centelles 45, Pta. 11
46006 Valencia, ESPAÑA
Tel: + 34 96 320 6491 FAX +34 96 320 7832
Móvil/Cell: +34 657 383 490
info@planetaupair.com
http://www.planetaupair.com

AU PAIR IN SPAIN APPLICATION FORM

All information is confidential and will not be shared with anyone other than Planet Au Pair and host families. Please print, fill out every section (use black ink) and send this application along with the photos and other documents listed on our web site. The application and documents can either be sent by post or fax and the photos can be sent by post or email.
 
________________________________________________________________________
Name:  Family                                        First                              Middle

Street _______________________________________________________________

City/State/Province______________________________________________________ 

Country_______________________________ Postal Code _____________

Telephone: ________________________ Best time to call ___________________  

FAX:  _____________________ Email:___________________________ 

Cell phone number: _________________ Passport number ___________________

Date of Birth___________  Religion_______________  Nationality________________

Height______  Weight______  Sex___  Occupation____________________

Preferred arrival/start date __________________ (Not guaranteed) End date ___________________

For how long? 1 mo.  ___ 2 mos. ___ 3 mos.___ (only in summer) 6 mos.____9 mos.____12 mos.____ longer__________

Please note for long-term stays, families prefer that you stay until the middle of June, regardless of when you arrive.

Previous occupation (s):____________________________________________________

______________________________________________________________________


Name, address and phone number of next of kin in case of emergency:

_______________________________________________________________________

________________________________________________________________________

Father's occupation___________________ Mother's occupation__________________

Brothers and sisters and their ages: _____________________________________________

When did you leave school?________ Qualifications___________________________

What are your career plans?___________________________________________________

Spanish proficiency level:  Excellent ____ Good____ Fair____ Poor____ None ___

Do you speak any other languages and at what level?__________________________

Do want to attend language classes?___________________

What is your experience with children and their ages:__________________________

______________________________________________________________________

______________________________________________________________________
 

What are your interests, hobbies and childcare related activities you can/would undertake?

______________________________________________________________________

______________________________________________________________________

Are you an animal lover?_______________ Do you have a full driver's license?_____

Are you prepared to drive a car with a manual shift? _____

Have you ever been away from home and,  if so, why, when and for how long?

______________________________________________________________________

______________________________________________________________________


Do you understand that you will be expected to help with the childcare related light housework? ______

Do you smoke? _____ If you smoke, would you be willing to smoke only outside of your host's home?_____

Do you understand that if you smoke against your host's wishes, they are completely within their rights to ask you to leave?_____

Will you accept a single parent family? Single father? ____ Single mother? ____

Do you have a special diet? _______ If so, please describe: _______________________

_____________________________________________________________________

Do you have any health problems?_____  Allergies?_____  Criminal record?_____

What ages of children do you prefer?___________  Do you like babies?______

How many children are you willing to look after?_______________

Do you wish to be placed near friends or relatives? If so, please give details____________

_____________________________________________________________________

Please note that the more flexible you are regarding location, the easier it will be to place you.

Do you want an Au Pair position (5 hours per day, five days a week, pay, 65 € a week)? _____

Or do you want an Au Pair Plus position (8 hours per day, five days a week, pay, 95 € a week)? ____

Either? ____

I, the undersigned, confirm that all the information provided above is true. I further understand that the minimum contract of service is for a period no shorter than the time specified on this application form.

Signed_________________________________ Date__________________

How did you hear about us?______________________________________________

Comments:






 

Conditions

In consideration of you, Planet Au Pair, accepting me for your Au Pair in Spain program, I hereby agree:

I AGREE:

1. to abide by all appropriate regulations and laws of Spain.
2. to carry out my duties as an au pair to the best of my ability.
3. to pay my way, to and from my home country and Spain.
4. to stay as long as I have indicated on my application.

I hereby warrant that all information I have given in the application is accurate and complete. I agree to perform my duties as an au pair to the best of my ability and indemnify Planet Au Pair and their staff against any loss or damage suffered by any of them or any claims made against them as a result of any breach or negligence by me during my participation in the program. I agree to indemnify Planet Au pair and their staff for any breach or negligence that the Spanish host family should cause me. I agree that  Planet Au Pair is merely an intermediary between myself and the Spanish host family. No applications, documents or photos can or will be returned for any reason. Once accepted and placed by Planet Au Pair, all fees paid are non-refundable. I agree to pay the placement fee invoice within seven days after receiving it and before departing for Spain.

It is agreed that Spanish law shall apply to this agreement and I agree to submit to the jurisdiction of the Spanish courts.
 


Signed______________________________________________ Date_______________________

 

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