Host Family Registration Form – Sakura Aupairs

Host family Registration Form

Host Family Registration Form

General Information

Email Address

Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Main contact person for aupair visa submission

Host Mother

Host Father

First Name (Main Contact)

Middle Name

Last Name

Profession

Employment Status

Employment contract

Entrepeneur

Director-shareholder (DGA)

Partnership

Other

Country of Nationality

Are you a single household?

Yes

No

Alternative contact person

First Name (Partner)

Middle Name (Partner)

Last Name (Partner)

Email (Partner)

Phone (Partner)

Profession (Partner)

Employment Status (Partner)

Employment contract

Entrepeneur

Director-shareholder (DGA)

Partnership

Other

Country of Nationality (Partner)

About your family

Number of Children in Household

Name of your child

Date of birth

Name of your child 2

Date of birth

Name of your child 3

Date of birth

Name of your child 4

Date of birth

Name of your child 5

Date of birth

Expecting a baby?

Spoken Languages

Do you have pets?

Yes

No

What kind of animals do you have?

Religion

Dietary Preference

Family Description

What kind of person will be a good match with your family?

Family Photos (it is also possible to share separately with us) - Please not that photos will be used for profile and might be shared with candidates.

Choose File

Preferences

Your weekly schedule

How aupair can support your children

How aupair can support around the house

Start date of the aupair

Second ideal start date of the aupair (if applicable)

Duration of stay

Pocket Money and additional allowance

Aupair Preferences (Select all that apply as a deal breaker for your family )

Experience with infants

Experience with toddlers

Driver's license

First Aid/CPR certification

Bike skill

Swimming skill

Non smoker

Any message for Aupair or Agency

In order to find the right match

Message for Aupair or Agency

Registration & Consultation Fee

Price: €170.00

Pay with Card (Stripe)

Please note that once you press ‘Submit’, your payment will be processed immediately.

© Sakura Aupairs EU B.V.

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