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HOST FAMILY APPLICATION FORM
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| First Name * | | Family Name * | |
| Are you a Single Parent? | YES NO |
| Spouse's Name * | | Family Name * | |
| Home Phone | | Work Phone * | |
| E-mail * | | Mobile * | |
| Fax | | Best time to reach you | |
| Address * | |
| Suburb * | |
| State * | | Postcode * | |
| How Many Children? * | |
| Age of Children? * | |
| Gender and Name? | |
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LIVE-IN CARE GIVER DETAILS
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| Starting Date * | | How long? | |
| Weekly wage | | How Many Hours? | |
| Please Describe in details Hours and Duties? |
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| Do any of your Children Attend School? |
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| Do any of your children have special needs? |
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| Do you have a private Bedroom for the Care Giver? |
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| Do you have a private Bathroom for the Care Giver? |
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| If NO, who will she share the Bedroom and/or Bathroom with? |
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| Will the Care Giver need to drive your car? Please Describe? |
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| How many care Givers have you had in the past 2 years? |
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| Do you have Internet Connection at Home? | YES NO |
| Can the Care Giver use the Internet during her Free Time? | |
| Please add any comments you think will be helpful to us |
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| Do you have any pets? Please Describe |
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| TERMS AND CONDITIONS |
- 1. I acknowledge that the Care Giver is here for the experience and will be treated with the utmost respect and as part of the family.
- 2. Au Pairs are usually here on a Working Holiday Visa and they have the right to work in Australia.
- 3. Work n Holiday will run a presentation and one to one interview before sending potential Care Givers to interviews to explain to the girls the system, family expectations, duties, etc...
- 4. Care Givers will receive FREE FOOD and FREE ACCOMMODATION during the experience.
- 5. If the family decides to go on holiday, the family will allow the Care Giver to stay at home (unpaid unless the family requests some housework to be done) or find the Care Giver a suitable accommodation for this period, otherwise there is no guarantee that the Care Giver will return to the family after their holiday.
- 6. The family will receive the file of the Care Givers by email 2-4 weeks before the arrival of the Care Giver. After reading the file the family might decide to accept the Au pair straight away after arrival or request an interview.
- 7. Please contact us regarding placement fees
We will invoice you as soon as the Care Giver moves in and the Due Date is strictly 4 weeks after the placement. If for any reason the Care Giver has to moved out before that period, we GUARANTEE A REPLACEMENT.
- 8. Work n Holiday is the main contact for families and Care Givers but we hold no liability or responsibility for any loss of items, dispute, or anything which might arise from mishandling the children, etc...
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| DECLARATION: |
- 1. I herewith secure, that all information given is absolutely correct and complete.
- 2. I confirm that I read and understood the Terms and Conditions.
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| Date | | Name * | |
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