Welcome to Ei International in cooperation with Au Pair Services Online Webform Application (For Host Family & AuPair Use)
Welcome to Ei International Multi-Services

Name *
Email Address *
Seeking for Host Family or Candidate
Address
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Company/Profession/Occupation
Telephone/Mobile
Best time to call you (local time)?

MM
/
DD
/
YYYY
Civil Status/ Age
For Candidate: Do/Can you/Are you/Will you?
 smoke 
 diet 
 have allergies 
 swim 
 bike 
 work for single parent 
 take care of pets 
 light houseworks 
 make the beds 
 wash-up 
 cook 
 shop for food 
 help in the garden 
 wash & iron 
 sew & mend clothes 
 willing to help than common 
Number of Children you want to take care & specify their ages?
For Candidate: Do you know how to?
 Look after baby(s) 
 Look after children ages 2-5 
 Look after children ages 5-10 
 Take care of disabled children 
 Change Diaper 
 Prepare a baby's bottle 
 Feed the baby with a bottle 
 Feed the baby with a spoon/fork 
 Get children up & dressed 
 Put children in bed 
 Keep children occupied 
For Candidate: Please give a detailed description of your childcare experiences you have cared for, their ages & your task?
Do you have a driving license? Date Issue/Exipre
For Host/Candidate: Details of Family Members/Ages
For Host/AuPair: Hobbies/Interest
For Host Only: Type of House/Specify Where
Knowledge of Languages
AuPair Hours of Duty & Wages:
Required Payment to your AuPair is from €300-€340 per month for 30 hours per week. Referred as pocket money. In Belgium is from €400-€450
Euros
.
Cents
Additional Hours should be paid pro rate and are negotiable between the host & the AuPair
For Host: Required hours on which days you need the AuPair to work? Specify the days/time (start/end)
For Host: Do you need your Candidate to or can?
 swim 
 bike 
 work for single parent 
 take care of pets 
 light houseworks 
 make the beds 
 wash-up 
 cook 
 shop for food 
 help in the garden 
 wash & iron 
 sew & mend clothes 
 willing to help than common 
For Host: Other Candidate Requirements
For Host: Would you help fund your Candidate Travel needs? If so, how much?
Euros
.
Cents
For Host: Will you cover your Candidate Holliday cost?
Euros
.
Cents
Where did you hear Our Candidate Services?
Additional Comments or Messages:
DECLARATION: Acceptance of Terms & Conditions
 by myself 
 with the help of someone 
I hereby declared that the above mentioned & online application documents I filled-up in full are all true & correct.
 Yes 
 No 
Date/Name/Signature
I Have Read & Agree to the Following Terms & Conditions & Settle my Registration Fee Payment
 Yes, I Agree 
Total Amount:
Euros
.
Cents
Image Verification
captcha
Please enter the text from the image:
[Refresh Image] [What's This?]
Powered byEMF Online Form
Report Abuse
Welcome to Ei International in cooperation with Au Pair Services Online Webform Application (For Host Family & AuPair Use