Form for Au Pairs

Contact details & Appearance
Family & Relationships
Appearances & Health
Religion & Eating habits
Education & Occupation & Personality
Hobbies & Time abroad & Pets
Skills & Experiences
Host family
Motivation & Expectations
Data privacy & Other information

Are you ...

Inbound

Outbound

Rematching host family in Belgium

Inbound means that you looking for a host family in Belgium. Outbound means that you are from Belgium and are looking to be an au pair elsewhere.

Are you a self-match?

Yes

Full Name of host family

Personal details

Surname

As indicated in your passport

First Name

As indicated in your passport

Nickname

Gender

Place of birth

Date of Birth

Please be aware that you can only apply as an au pair if you are 25 years or younger. If you are 26 years old oder older you will not be able to submit this form.

Nationality

Are you a citizen of a European (EU) country?

Yes

Passport number

Please upload a picture of your passport

Maximum file size: 1MB

Please upload your residence permit if you are not living in your home country

Maximum file size: 1MB

Please upload your work permit if you do not hold an EU passport

Maximum file size: 1MB

Please upload your visa if you do not hold an EU passport

Maximum file size: 1MB

Please upload a police clearance if you have one

Maximum file size: 26.21MB

Please enter your postal address where we can send documents like the au pair contract to.

Street & Housenumber

Postal Code

City

Country

Home phone number

Mobile number

WhatsApp/Telegram Number (if different)

If you share your what's app number with us you automatically consent that we may add you to what's app groups.

I hereby agree that I can be contacted via WhatsApp/Telegram

Yes

Email Address

Enter your Email Address

Confirm Email Address

Confirm your Email Address

Password

Eight characters minimum One lowercase letter One uppercase letter One number One special character

When you register with our agency, you automatically create an account which allows you to update your profile. Please make a note of the password to log in later.

Confirm Password

URL to your personal introduction video

Skype Address

Facebook Address

What embassy are you applying at for the au pair visa?

What airport will you be departing from?

Rematching

I am looking to change host family

Yes

Street and house number of your current host family *

Postal code *

City

Country

Reason you wish to change family

Visa valid from

Please upload a picture of your current visa

Maximum file size: 1MB

Earliest date for changing family *

Has the au pair contract between the host family and you been formally terminated?

Yes

Please upload the letter of termination

Maximum file size: 1MB

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