0% Contact details Name * First name * E-mail * Mobile Previous Next Family composition Number of children * Boy(s) Girl(s) Age * Previous Next Your future au pair Driving licence required? * Yes No Preference for a specific nationality? * Yes No If so, which nationality? Preference for a specific language? * Yes No If so, which language? Previous Next Tasks Babysitting * Choose an option Yes No Sometimes Babysitting during the weekend * Choose an option Yes No Sometimes Babysitting during the evening * Choose an option Yes No Sometimes Assistance with homework * Choose an option Yes No Sometimes Driving the children to activities / school * Choose an option Yes No Sometimes Cooking a simple meal * Choose an option Yes No Sometimes Bathing children * Choose an option Yes No Sometimes Feeding a baby * Choose an option Yes No Sometimes Making the beds * Choose an option Yes No Sometimes Ironing * Choose an option Yes No Sometimes Empty the dishwasher * Choose an option Yes No Sometimes Shopping for food * Choose an option Yes No Sometimes Cleaning the kitchen * Choose an option Yes No Sometimes Taking the dog for walk * Choose an option Yes No Sometimes Others? Tidy up * Choose an option Yes No Sometimes Additional comments (house rules, expectations, special skills, etc.) We declare that the information provided in this application form is true and correct. Any incorrect or false answers may result in the cancellation of the registration. We will comply with the legal provisions concerning au pairs in Belgium * Yes, the information provided in this application form is true and correct. Submit Previous Next
