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This is the Au pair application form and agreement
of
Filippijnse Au Pair.
This form is
your first step to become one of our best
philippine au pairs in The Netherlands.
Kindly read, understand & discuss with
your family first, before signing the FAP au
pair application form & agreement.
Once you affixed your signature below, it is
clearly manifest that you understand our
rule.
Send
us all copies of your diplomas + a copy of
your medical report + copy of authenticated
birth certificate
IINSTRUCTIONS:
1. Fill in this form by computer (never fill
in more letters than fitting in the field),
2. Click
PRINT, 3. Put your name, signature and date,
4. SCAN all pages (minimum resolution
1400 x 2000 pix), 5. E-mail the scans
to
info@filippijnseaupair.nl.
After we received all
scans and you are satisfactory our demands,
you will receive an interview. |
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Personal details |
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| Surname |
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| First name |
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| Middle name |
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| Street
address |
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| Post code |
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| City |
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| Province |
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| Region |
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| Country |
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| Telephone
number, home |
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| Mobile phone
number |
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| Telephone
number, work |
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| E-mail
address |
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| Date & place
of birth |
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| Age |
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| Gender/sex |
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| Nationality |
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| Bank account
number (optional) |
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| Passport
number |
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| Date and
place of issue |
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| Expiration
date |
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| Religion |
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| Do you
regularly attend religious services? |
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| Height |
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Weight
(May be included in medical report) |
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| Are you
willing to live in a family with animals? |
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| Have you ever
lived away frome home for any lenght of time (i.e. 2
months ore more)? |
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| Give details |
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| Health |
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| Are you
healthy? |
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| If not,
please explain |
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| Are you
allergic to animals? |
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| Do you have
any other serious allergies? |
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Please
describe
(Can be included in medical report) |
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Do you have a
special diet
(e.g., vegetarian)? |
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| If yes,
please explain |
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| Smoking |
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| Do you smoke? |
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| If you smoke,
are you willing to refrain from smoking in the host
family's house or in the presence of the children? |
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| Ride a
bike |
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| Can you ride
a bike? |
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| Driving |
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| International
drivers license? |
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| If yes, when
did you receive the license? |
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| How much
experience do you have? |
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| Are you
willing to drive in the host country? |
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| Family
background |
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| Parents'
address |
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| Parents'
telephone number |
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| Parents'
e-mail address |
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| Fathers
occupation |
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| Mothers
occupation |
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| Brothers? |
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| If yes, names
and ages |
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| Sisters? |
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| If yes, names
and ages |
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Contact
person in case of emergency
(If other than parents) |
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| Education |
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| Name and
place of University |
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| Duration |
4 years
longer
then 4 years |
| Diploma |
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| Name and
place of High school |
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| Diploma |
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| Do you have
any knowledge of first aid or life-saving? |
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| If yes, do
you have any certificates? |
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| Have you
taken any course relating to child care? |
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| If yes, do
you have any certificates? |
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| Hobbies &
interests |
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| What are your
special hobbies/interests? |
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| Do you
participate in sports? |
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| If yes, in
what sports? |
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| Do you swim? |
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| Do you have
any background in music or dance? |
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| If yes, give
details |
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| Do you like
traveling? |
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| Employment
record |
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| Past
employment |
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| Present
employment |
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| Experience
with children |
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| Do you have
any experience with children? |
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| 0-3 years? |
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| If yes, how
often? |
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| 3-6 years? |
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| If yes, how
often? |
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| 6-10 years? |
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| If yes, how
often? |
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| Older than 10
years? |
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| If yes, how
often? |
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| Do you have
any experience with disabled children? |
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| If yes, give
details |
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| Have you ever
been an au pair before? |
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| If yes, in
what country and for how long? |
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Preferences |
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| Child age
group you prefer to work with? |
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| 0-3 years? |
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| 3-6 years? |
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| 6-10 years? |
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| Older than 10
years? |
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| Are you
willing to take care of a disabled child? |
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| Would you
prefer to be placed in a family with 1, 2, 3 or 4
children, or more? |
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| Are you
willing to work with a single mother? |
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| If not,
please explain |
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| Are you
willing to work with a single father? |
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| If not,
please explain |
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| Are you
willing to work with families of all ethic and religious
backgrounds? |
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| If not,
please explain |
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| Would you
prefer to live in a big city, a small town, a suburb or
in a rural area? |
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| Do you like
cooking? |
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| Experience
with household |
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| Do you have
experience with household? |
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| If yes,
please give details |
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| Can you cook? |
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| If yes, Philippine
dishes? |
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| If yes, Indonesian
dishes? |
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| If yes, Chinese
dishes? |
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| If yes, European
dishes? |
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| If yes, Other dishes? |
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| English |
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| Do you speak
fluently English? |
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| Do you hear
fluently English? |
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| Do you read
fluently English? |
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| Dialect |
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| Verbal skills? |
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| Number of
years studied, certificates held |
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| Language &
culture of your host country |
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| It is
required to study the language and culture of your host
country. Do you agree with that? |
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| Reasons
for applying |
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| Why do you
want to be an au pair? |
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| Why do you
want to travel abroad? |
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| Why to The
Netherlands? |
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| Contact
person |
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| Do you have a
contact person in The Netherlands? |
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| If yes, name |
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| address, |
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| e-mail
address |
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| telephone
number |
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| Agency fee |
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| The agency
fee is P38,000 |
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| After 1 year
registration, P20,000 of the agency fee is refundable,
when none of our host families have choosen for you as
their au pair. If you choose for refunding, our
mediation ends after 1 year registration. |
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| I choose for
refunding |
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| If you choose
for not refunding, our mediation goes on till you are 25 years of age |
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| I choose for
mediation till i am 25 years of age |
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Conditions |
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| With signing
the au pair application form & agreement, the au pair
agrees with all conditions from Filippijnse Au Pair (FAP)
written & stated below: |
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Kindly
read, understand & discuss with your family first,
before signing the FAP au pair application form & agreement.
Once you affixed your signature below, it is clearly
manifest that you understand our rule. |
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| 1. Upon
signing the au pair application form and agreement &
payment of the agency fee of P38,000, will be the
start of our mediation. You can pay P28,000 as initial
payment & the balance (P10,000) is payable before or
after the visa is released. |
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| 2. The au
pair will be the one processing her documents and pays all expenses, made in
the Philippines to obtain the necessary papers (birth-
and single certificate, certificate of civil status,
medical form, passport copies, photos, record of
Clearance of National Bureau of Investigation, travel
insurance, terminal fee, etc... |
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| 3. The host
family pays the au pairs flight ticket, liability &
health insurance, visa, language study, family trips and
they have the obligation to pay the au pair a monthly
pocket money from 300 euro for an au pair whitout High
school diploma, 320 euro for an au pair with
a High school diploma and
340 euro for an au pair with a University
diploma after four years of study. |
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| 4. FAP is not
responsible for any damage to the host family, caused by
the au pair. |
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| 5. The host
family has the obligation to give you a room of your own.
In there, they have to respect your privacy |
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6. Your au
pair work is to take care for the children/adults and do
light household works, like washing the dishes, cleaning
the kitchen, ironing, etc, for not more than 30 hours a
week.
You will work 5 days a week The host family may
ask the au pair to babysit for 3 evenings per week. |
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| 7. The au
pair is allowed to phone once a month to the Philippines
or get an Asia card from the host family, amounting from
10 euro to 15 euro per month. |
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| 8. The au
pair has 2 weeks, paid vacation. |
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| 9. The au
pair has 1 long weekend (friday 18.00h.-monday 12.00h.),
per month. |
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| 10. When the
host family goes on holidays without the au pair, they
have the obligation to give the au pair an allowance for
food supplies |
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| 11. When the
au pair has a problem with the host family, the au pair
tries to solve it, by talking about it with the host
family. When the au pair is unable to solve it, then
please contact our office: 010-8444416 or 06-42272666
(mobile) immediately. |
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| 12. You've
never stayed as tourist or au pair in The Netherlands
before. |
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| 13. You
have no kids. (Take notice: when we find out that you
have (a) kid(s), you will be send back to the
Philippines immediately) |
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| 14. You
have no relatives who are depended of you. |
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15.
Affix your signature on the last page of the
application and agreement form.
No signature, no mediation policy. |
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| 16. Once
you have a host family already, you cannot withdraw your
application as au pair because if do so, you will pay
the expenses incurred by your host family in processing
your visa approval in The Netherlands (P30,000). |
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| 17. Visa for au pair can be denied also for some valid reasons.
But if incase it happened to you, we will then
prioritize you to get a host family at once. You will
then process your documents at your own expense again.
This is more then a risk. |
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| 18. Be
open & frank to your host family & make them feel
comfortable with your stay with them. Gossiping is
strictly prohibited. |
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| Signature |
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| Name
__________________________ |
Signature
____________________ Date __________ |
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| © Filip |
pijnse Au Pair |
