If yes, please explain: 
If yes, please explain:  
If yes, please explain:  
If yes, please explain:  
If yes, please explain:  
If yes, please explain:  
If yes, please explain:  
If social smoker, how often? 
If yes, please explain: 
If yes, please explain: 
If yes, please indicate when, where, why and for how long? 
If yes, please indicate when and where we can reach you while you are away: 
If no, do you intend to further your education? 
Please specify your educational information. 
If yes, please specify your employment experience besides work caring for children. 
If yes, please describe: 
Describe your hobbies/interests a bit further or list any other hobbies not listed above: 
If yes, please list what pets you cannot live with and the reason: 
If yes, please specify your tutoring objects (pupils) and general methods: 
Please describe how you plan to assist your Host Family with child education, especially foreign language tutoring: 
What activities (both outdoors and indoors) would you like to do with the children in your Host Family? 
Why should a family choose you as their Au Pair? 
*Please describe: 
*Please describe:  
Describe talents/skills you have that are useful when caring for children: