Au-pair Registration Form Complete our easy-to-use form below and your details will be online for Families to contact you directly with Job offers. Once successfully completed you will be Emailed a Username & Password to Log-in and search.  Please choose a Username: (Required - Min 6 Char - Max 10 Which Country are you from? (Required) SelectAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and herzegowinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCook IslandsCosta RicaCote D'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEstoniaEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands [malvinas]FijiFinlandFranceFrench GuianaFrench Overseas PosessionsGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuineabissauGuyanaHaitiHondurasHong kongHungaryIcelandIndiaIndonesiaIran [Islamic Republic of]IraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, People's RepublicKorea, RepublicKuwaitKyrgyzstanLatviaLao People's Democratic Republic [Laos]LebanonLesothoLithuaniaLiberiaLibyan Arab JamahiriyaLiechtensteinLuxembourgMacauMacedonia, the former YugoslavMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMexicoMoldova, RepublicMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorwayOmanPacific Islands of MicronesiaPacific, ThePakistanPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSabaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakia [Slovak Republic]SloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt EustatiusSt MaartenSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTahiti [French Polynesia]Taiwan, Republic of ChinaTajikistanTanzania, United RepublicThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican City State [holy see]VenezuelaVietnamVirgin Islands - britishVirgin Islands - USYemenYugoslaviaZaire [democratic Republic of Congo]ZambiaZimbabwe Which Country would you like to go to? (Required) SelectAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaireBosnia and herzegowinaBotswanaBrazilBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCook IslandsCosta RicaCote D'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEstoniaEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands [malvinas]FijiFinlandFranceFrench GuianaFrench Overseas PosessionsGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuineabissauGuyanaHaitiHondurasHong kongHungaryIcelandIndiaIndonesiaIran [Islamic Republic of]IraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, People's RepublicKorea, RepublicKuwaitKyrgyzstanLatviaLithuaniaLao People's Democratic Republic [Laos]LebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLuxembourgMacauMacedonia, the former YugoslavMadagascarMalawiMalaysiaMaldivesMaliMaltaMartiniqueMauritaniaMauritiusMexicoMoldova, RepublicMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorwayOmanPacific Islands of MicronesiaPacific, ThePakistanPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSabaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakia [Slovak Republic]SloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSt EustatiusSt MaartenSudanSurinameSwazilandSwedenSwitzerlandSyrian Arab RepublicTahiti [French Polynesia]Taiwan, Republic of ChinaTajikistanTanzania, United RepublicThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican City State [holy see]VenezuelaVietnamVirgin Islands - britishVirgin Islands - USYemenYugoslaviaZaire [democratic Republic of Congo]ZambiaZimbabwe Your Full name: Telephone number: (If entered it will be shown to families) Email address: (Families will contact you at this address - check carefully!) Nationality: Religion: Gender: (Required) Female Male Start date: (Required) November 2008December 2008January 2009February 2009March 2009April 2009May 2009June 2009July 2009August 2009September 2009October 2009 Length of stay: (Required) 2 Months3 Months6 Months12 Months18 Months24 Months Age: Your Marital status? Married Single Seperated Divorced Are you pregnant? Yes No Do you drive? Yes No How long have you been driving? Will you drive as an au-pair? Yes No Can you swim? Yes No Do you smoke? (Required) Yes No How many per day: Will you smoke only outside the families house? Yes No Will you cook simple meals? Yes No Do you speak any of these languages: English French Spanish Italian German How well do you speak the language of the Country you want to go to? Poor Moderate Good Very Good Do you want to take language classes? Yes No Mothers occupation: Fathers occupation: Are you happy to do light housework? Yes No Can you Iron? Yes No Do you like animals? Yes No Are you allergic to anything? Are you suffering from any medical condition that could affect your work? Are you happy to work with all ages of children? Yes No Which age groups do you have the most experience: 0-3 3-6 6-11 11-16 Do you like babies? Yes No Have you had any practice in the care of children or babies? Yes No What hobbies and leisure activities do you enjoy: Have you been an Au-pair before? Yes No Where do you prefer to stay? (You will receive more job offers if you are  prepared to be placed anywhere) Anywhere Country or rural area Town Capital City only (like London, Washington) What education and qualifications do you have? What jobs have you done: Are you currently: Employed Unemployed Student Under Notice Will you accept a single parent family with no mother? Yes No Tell the family a bit about yourself: Say something about yourself to help families get to know you. You will receive much more interest from families if you tell them about yourself such as: your experience, hobbies, why you want to be an au-pair etc.   Please DO NOT enter contact details in this section or your profile will not be accepted!   Have you at any time been convicted of any criminal offence? Yes No Photograph Upload:DO NOT TYPE IN BOX PLEASE! Click on BROWSE to find a picture on your computer to upload. (Families are more likely to contact you if you add a photo) Where did you hear about us? SelectSeek.netLocal PaperGoogleAltavistaYahooAsk JeevesExiteHotbotFriendOther Please only submit once - Multiple entries will not be added!

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