Au-Pair Application Form
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Surname/Family Name *
First Name *
Address *
Email *
Nationality *
Gender *
Date of birth *
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/
DD
/
YYYY
Telephone *
Best time to call me in my country *
How long do you intend to stay? *
Earliest date to travel to Ireland: *
MM
/
DD
/
YYYY
Latest date of travel to Ireland: *
MM
/
DD
/
YYYY
What kind of area do you prefer?
Clear selection
Do you hold a current relevant driving licence? *
And are you willing to drive while in Ireland?
Do you smoke? *
Can you swim? *
Would you be willing to prepare meals for the family? *
Would you be willing to do light household chores? *
Do you like animals? *
Do you have knowledge of first aid? *
Are you willing to stay with a single mother? *
Are you willing to stay with a single father? *
What is you English language ability? *
Do you speak any other language? *
Besides English and your native language?
Do you have any childcare qualifications/training/diplomas or certificates? *
i.e. First Aid, CPR, etc.?
Do you have any experience minding/taking care of children? *
What ages do you prefer? *
Required
Have you any experience with meal preparation? *
Have you any experience with bathing children? *
Have you any experience with playing with children? *
Have you any experience with helping with schoolwork? *
Have you any experience with putting children to bed? *
Have you any experience with preparing babies' bottles? *
Have you any experience with changing diapers? *
Have you any experience with bathing babies? *
Do you have experience with disabled children?
If so what?
Clear selection
Who do you live presently live with? *
How many siblings do you have? *
And their ages?
What is your mother's occupation?
What is your father's occupation?
Have you ever lived away from your family for 2 months or more? *
Have you ever lived outside your country for more than a brief holiday? *
What hobbies and activities do you enjoy doing in your spare time? *
Do you have any dietary or medical requirements?
Do you have any chronic health problems? *
For example: epilepsy, asthma, diabetes.
Please tell us a little about your life in your home country, and your goals while you will be living abroad. *
Please tell us a little about any experience you have working with children *
"Dear Host Family" Letter
You are also required to write a letter about yourself which will be shown to potential host families. This can be emailed later to info@languageacademyireland.com along with a few photos of yourself. Some tips for writing the letter:

1 – Address your letter to “Dear Host Family”.

2 – Introduce yourself, where were you born and where you live now.

3 – Describe your family, including sisters and brothers and your parents’ occupations.

4 – Describe your community and its location in your country.

5 – Describe the children you have cared for and the type of things you have done with them.

6 – Share information about yourself and what you enjoy doing.

7 – Share your goals for the future.

8 – Describe your interest in living in Ireland and being a part of an Irish family.

9 – Explain why you want to be an Au Pair/ Demi Pair and what you hope to gain from this experience.

10 – If English is not your native language and you are uncomfortable writing in English you might refer to an English translator dictionary for help. We recommend you use words that you are most comfortable speaking.

Please attach two character references with your letter.

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