Be an Au Pair in France with

Become bilingual! Be an Au Pair in France with no programme fees for EU candidates! Make new friends APITU! www.ufaap.org www.iapa.org Looking for a cultural exchange? Want to care for children whilst travelling? Join us for 2 to 24 months working as an au pair in France! Being an au pair Studying French (up to 10hrs per week) Exposing families to different cultures & offering children wonderful experiences 30 hours childcare a week APITU is a family-run agency created in 1992. We are full members of The UFAAP and IAPA which ensure you of the high quality of our services. We have over 20 years experience organising high quality au-pair placements. We have earned a solid reputation through our rigorous selection of families and au-pairs, taking into consideration the needs of both parties. Our agency is British run and based in Brittany. You may apply if you: Typical day as an au pair Are aged between 18-29 years old. Have appropriate child care experience. Have no criminal record. Have some basic knowledge of the French language. Want to live with a French family and enjoy caring for children. Preparing meals for the children/ bathing and dressing them/ driving the children to school / putting them to bed Playing with the children/ babysitting/ helping them with their homework Washing up/ sweeping/ vacuuming/ helping to clean up after meals and ironing the children s clothes. Your placement is a commitment to the children and their parents. 16 Boulevard Victor Planson - 35120 Dol de Bretagne Page 1/20

Advantages : The opportunity to spend from 2 months up to 2 years in France. The opportunity to call one or several of the ex-au pairs who have completed the program. Screening of host families to ensure they are appropriate for the program. Private or independent room + 3 meals/day. 2 weeks paid holiday if you complete 12 month program or o 1 week for the 6 months program and all bank holidays off (or paid extra if worked). Assistance and support in organising your arrival. 80 per week pocket money + local public transport costs to French school. Au pair club: contact details of others au pair and social activities organised. 20 years experience at your service: local Resident Director to provide help and guidance during your stay. Emergency phone number and lodging. Medical insurance paid by family (100% medical, civil liability, repatriation). Application checklist : Your application form can be emailed to us The completed application form and your C.V. with an identity photo. Photographs of you, your family, friends and children you have cared for. If possible a video to present yourself to potential families. Dear Host Family letter in French (if not, in English). A minimum of one childcare reference from your previous childcare employer and one character reference. Medical Certificate and its translation into French. Photocopy of your passport and driving licence (if applicable). Any other documents of interest (First Aid Certificate, Childcare diploma, etc). School Certificates and their translation into French. Resume (CV) preferably in French (if not in English). Criminal record. Translations: you can translate your documents yourself into French; if not into English. Countries: no program fees Please check if you are in the following European countries, which will indicate if you require a Visa or not. AUSTRIA ESTONIA LATVIA ROMANIA BELGIUM FINLAND LITHUANIA SLOVAKIA BULGARIA GERMANY LUXEMBOURG SLOVENIA CROATIA GREECE MALTA SPAIN CYPRUS HUNGARY NETHERLANDS SWEDEN CZECH REPUBLIC IRELAND POLAND UNITED KINGDOM DENMARK ITALY PORTUGAL 16 Boulevard Victor Planson - 35120 Dol de Bretagne

The process : 1. Complete your file and send it to us via email. 2. Upon reception we will screen your file and contact you for further information (and to organize a skype interview). 3. We will select families that suit you best and send them your file. 4. You will receive telephone calls from families who are interested in welcoming you as their au pair (a placement can only be confirmed after a telephone call). 5. Upon placement we will help you organize your prescription arrangements and visa (if required). Your French skills : 6. Upon arrival you will receive your Welcome Pack and be invited to join our Au Pair Club You will receive several hours a week of classroom teaching, plus access to the school library. You will be studying at a school which will be a recognized Educational Institution (at your own expense). The goal for the courses is for the au pairs to consolidate their knowledge of the French language. You will practice both written and spoken French and be prepared for French examinations. The courses follow the same calendar as the French school year. The cost of the school varies (maximum 40% of your salary) but part of these costs may be paid by the family. You will also study a sufficient amount of grammar of 4 hours per week. Moreover, living with your host family and making new French friends will greatly improve your French skills. Services : Insurance and Social As an Au Pair, you will benefit from the French National Health system. You will have to pay for any prescription that you will receive from the doctor, but this will be refunded to you by your private insurance that all families are obliged to take out for you. The family: if you are not happy In the event of conflicts, your Resident Director will be called upon to assist. In the case of extreme conflict, the Resident Director may recommend a transfer to another family. In the case of extreme dereliction of duty where the Resident Director believes that you have proved unsatisfactory and cannot be placed with a new family, or if you leave your host family without your Resident Director s permission, you will receive no refund of fees. Behaviour that will not be tolerated includes neglect, improper care or abuse of the children whilst under your supervision, general irresponsibility and unacceptable personal behaviour such as the use of drugs or alcohol. 16 Boulevard Victor Planson - 35120 Dol de Bretagne Tél. : + 33 (0) 2 99 73 22 36 Email: apitu@apitu.com - Web Site: www.apitu.com Page 3/20

Useful information AU PAIR CLUB: The return journey from France to your country is at your expense, as is the cost of the French school. In most cases, but not all, some families will help you with your school fees. You must have a sufficient amount of money with you when you arrive to cover initial costs. We recommend Visa or Master Card. Your Host Family will understand your feelings, concerns and nervousness of arriving into a foreign family and a new country, but remember - your Host Family is going to be as nervous as you will be. It is up to both parties to make an effort in the beginning and the best way is to communicate when you are facing issues and to be open-minded. WELCOME PACK (advice on living with a local family, obligations and duties ) Get-togethers throughout the year Contact with students End of year diploma Facebook private list Emergency call n 24/7 Emergency lodging During your stay, if you wish to invite friends or a member of your family, you must of course ask permission from your Host Family. Association Apitu @ApituAsso DO NOT HESITATE TO CONTACT US IF YOU WOULD LIKE MORE INFORMATION WE LOOK FORWARD TO SEEING YOU IN FRANCE! 16 Boulevard Victor Planson - 35120 Dol de Bretagne Tél. : + 33 (0) 2 99 73 22 36 Email: apitu@apitu.com - Web Site: www.apitu.com

REGISTRATION FORM AU PAIR EN France You must attach the following to your file / Vous devez joindre à votre dossier The registration form (to be completed in block capitals in black ink) / La fiche inscription ( compléter en lettres majuscules) The reference forms If your referee has a good knowledge of the French language you can ask him directly fill the form in French. If your referee does not know French well, ask them to fill out the form in English and use the translation form from English into French language. Remember to make as many copies as necessary of references and to provide us at least one character reference and one childcare reference (but more would be great) 1. Reference form of childcare(s) may be supplemented by any person for whom you are baby-sitting or other childcare. 2. Character Reference Form: can be completed by any person (excluding family members): a friend of the family, a teacher (ideally in French) Les formulaires de références. Si votre référant maîtrise la langue anglaise vous pouvez lui demander de remplir directement le formulaire en langue anglaise. Si votre référant ne maîtrise pas la langue anglaise, demandez-lui de remplir le formulaire en langue française et faites vous-même la traduction sur le formulaire en langue anglaise. 1- Formulaire de référence de garde d enfant(s) : peut être complété par toute personne pour qui vous avez fait du babysitting ou autre type (1 minimum mais plus est mieux) 2- Formulaire Référence de caractère (1 minimum) : peut être complété par toute personne (hors membre de votre famille) : un(e) ami(e) de la famille, un professeur (d anglais idéalement), un(e) ami(e) de longue date, Pensez à faire autant de copies que nécessaire des références afin de nous fournir au minimum 1 référence de caractère et 1 référence de garde d enfant(s) The medical certificate to be completed by your doctor / Le certificat medical completé par votre médecin The contract (to be returned with your completed application) / Le contrat ( à retourner avec la fiche inscription) Résumé in french / CV en Français Letter of motivation to French family / Lettre de motivation à ta famille au pair 4-5 photos (appropriate portrait photos with your friends and family, hobbies, in action with children) / ( photos avec tes amis, ta famille, tes loisirs, avec des enfants) Copy of criminal record / Casier judiciaire Copy of last degree (translated into French if non EEC member) / Copie de votre dernier diplôme Copy of passport (or ID if EEC member) / Copie de votre passeport (ou carte d identité si UE) Copy of an international driving license (recommended) / Copie du permis international ( recommendé ) First Aid Certificate (optional) / Certificat de secourisme (optionnel) A video to present yourself (if possible!) / Une video pour vous présenter (si possible!)

Notes particulières au dossier d inscription 1. Soignez la présentation, c est essentiel / pay attention to presentation, it s essential 2. Pensez à compléter tous les champs / remember to complete all the fields 3. Si vous n avez pas d adresse skype créez-vous en une (toutes les familles souhaitent aujourd hui communiquer par Skype)/ If you don t have a Skype address, create one (every family would like to speak with you by Skype!) 4. Essayez d être le plus flexible possible considérant que cela ne fera qu augmenter le nombre de familles que nous pourrons vous proposer (mais ne vous forcera pas à en accepter une)/try to be the most flexible as possible, as it increases your chances of placement 5. Soyez précis dans vos réponses pour les dates de départ et de retour / be specific in your answers to the dates of departure and return 6. «Children with disabilities» : il ne s agit pas uniquement d enfant avec un handicap lourd!! Il peut être question simplement d un enfant allergique ou avec un handicap physique léger / It s not only children with a physical disability. It maybe just a child with an allergy! 7. N hésitez pas à nous contacter pour toutes questions lorsque vous remplissez le dossier. Les procédures sont plus rapides lorsque le dossier est complet dès la réception / Do not hesitate to contact us if you have any questions. Procedures are faster when we receive a complete file from the start! 8. Il est préférable de joindre un clip vidéo à votre candidature afin que la famille puisse vous connaître au mieux / It s better to attach a video clip to your application so that the family can get to know you better. Comment faire la vidéo / How do the video Pensez aux sujets dont vous aimeriez discuter / Think about subjects that you would like to speak about Vos centres d intérêts Centers of interest Votre experience en garde d enfants Your experiences of childcare Vos motivations Your motivations Votre pays, votre culture Country, culture Votre famille Family Recommandations / Recommendations Enregistrez votre vidéo dans un endroit calme : chez vous, dans votre jardin, dans un parc. Evitez les fonds sonores (musique, circulation, ) Record your video in a quiet place, at home, in your garden, in a park Adressez-vous à la camera et proche du microphone de façon à ce que vous soyez visible et audible (c est vous que la famille souhaite voir et entendre!) Please stay the nearest from camera and microphone to be visible and audible Ne donnez aucun renseignement personnel (nom de famille, téléphone, adresse,..). Ces informations sont déjà dans votre dossier Do not give any personal information (name, phone, address...). This information is already in your file. Montrez votre personnalité Show your personality N oubliez pas de sourire! Do not forget to smile! Envoyez-nous votre vidéo par email : apitu@apitu.com Send us your video by mail (N oubliez pas de nous indiquer votre nom complet dans cet émail! / Do not forget to indicate your full name in the mail! ) Informations utiles / Useful information : Nous acceptons les clips vidéo aux formats / We accept video clip formats : t.mov.wmv.avi.mp4.flv.mpeg et.mpg Votre clip ne doit pas dépasser les 8Mo / Your clip must not exeed 8Mo Votre vidéo sera convertie en 320 x 240 pixels. Ce n est pas une qualité extraordinaire. Assurez-vous donc qu elle contient surtout des gros plans / Your video will be converted to 320 x 240 pixels. This is not an extraordinary quality. So make sure it contains mostly close-ups Notre agence visionnera votre vidéo afin de la valider avant de l envoyer aux familles potentielles / Our agency will watch your video to check it before sending it to prospective families

FEUILLE D INSCRIPTION / APPLICATION FORM DATE DE COMMENCEMENT AU PLUS TOT... DATE DE COMMENCEMENT AU PLUS TARD... EARLIEST DATE TO START LATEST DATE TO START DUREE DE SEJOUR... DATE DE FIN DE SEJOUR AU PLUS TARD... LENGH OF STAY LATEST DATE YOU NEED TO RETURN HOME VILLE SPECIFIQUE / REGION... SPECIFIC TOWN / AREA Etat Civil NOM ET PRENOM... ADRESSE...... TELEPHONE EMAIL SKYPE AGE...DATE DE NAISSANCE :.LIEU DE NAISSANCE... DATE OF BIRTH... NATIONALITE... RELIGION... NATIONALITY N DE PASSEPORT... DATE D EXPIRATION... PASSPORT NUMBER DATE OF EXPIRY PROFESSION DE VOTRE PERE... DE VOTRE MERE... FATHER S PROFESSION... AVEZ-VOUS DES FRERES ET SŒURS? AGES... DO YOU HAVE ANY BROTHERS OR SISTERS? AGES. AVEZ-VOUS DES PROBLEMES DE SANTE? SI OUI, DESCRIPTION... DO YOU HAVE ANY HEALTH PROBLEMS? IF SO PLEASE DESCRIBE SUIVEZ-VOUS UN REGIME ALIMENTAIRE? SI OUI, DESCRIPTION... DO YOU FOLLOW A SPECIAL DIET? IF SO PLEASE DESCRIBE. TAILLE... POIDS... HEIGHT... Formation scolaire et Compétence AVEZ-VOUS VOTRE PERMIS DE CONDUIRE? OUI NON SI OUI, DEPUIS QUAND?... DO YOU HAVE YOUR DRIVING LICENSE? IF SO, SINCE WHEN? VOUS POUVEZ CONDUIRE UNE VOITURE AUTOMATIQUE UNE VOITURE MANUELLE YOU CAN DRIVE AN AUTOMATIC CAR A MANUAL CAR SERIEZ-VOUS PRET A AVOIR PLUS DE LEÇONS DE CONDUITE AVANT VOTRE ARRIVEE? YES NO WOULD YOU BE WILLING TO TAKE ANOTHER DRIVING TEST BEFORE YOUR ARRIVAL?

Quand avez-vous commencé à conduire (inclue vous leçons de conduites)? When did you first start driving (including your driving lessons in order to take your test)? Quand avez-vous eu votre permis de conduire, quelle sorte de test? How did you get your driving license, what sort of test? Durant les deux derniers mois, combien de fois avez-vous conduit (Merci de nous donner des détails, pas seulement la fréquence, mais aussi le type de voiture et de route) For the past 2 months how often have you been driving (please detail not only frequency but type of car and routes)? Donnez le modèle de chaque voiture que vous avez déjà conduit régulièrement (manuel/ automatique, taille de la voiture (petite, moyenne, familiale), propriétaire de la voiture (vous, amis, famille...) Please give the model of each car you have been driving on a regular basis (manual / automatic, size of the car (small/medium/family), owner of the car (you/friends/family/...) 1.... 2.... 3.... 4.... 5.... Avez vous déjà eu votre propre voiture? Have you ever had your own car? Avez-vous déjà été assurez à votre propre nom? Have you ever been insured in your own name? Avez-vous déjà eu un accident? Si oui, décrire Have you ever had a car incident? If so describe Avez-vous déjà conduit en ville? Si oui, préciser Have you ever driven in a town? if so specify. Avez-vous déjà conduit à la campagne? Si oui, préciser Have you ever driven in the countryside? if so specify. Avez-vous déjà conduit en montagne? Si oui, préciser Have you ever driven in the mountains? if so specify. Avez-vous déjà conduit sur une autoroute? si oui, préciser Have you ever driven on a motorway? If so specify. Te sens-tu à l aise pour conduire en France (notez de 1 à 5, 1 étant le moins à l aise) How comfortable do you feel about driving in France (rate 1 to 5, 1 being the least comfortable)? Sur une autoroute :... A la campagne :... Dans un village:... On the motorway:... In the countryside:... In a village:... En ville :... A la montagne :...

In a town:... In the mountains:... PRECISEZ VOTRE NIVEAU DE FRANÇAIS COURANT BON MOYEN DEBUTANT SPECIFY YOUR LEVEL OF FRENCH FLUENT GOOD AVERAGE POOR COMBIEN D ANNEES AVEZ-VOUS ETUDIE LE FRANCAIS?... FOR HOW MANY YEARS HAVE YOU BEEN STUDYNG FRENCH AUTRES LANGUES 1.... COURANT BON MOYEN DEBUTANT OTHER LANGUAGES 2.... COURANT BON MOYEN DEBUTANT NIVEAU D ETUDES ET DESCRIPTION... LEVEL OF STUDIES... Expérience en garde d Enfants Childcare Experience form Merci de compléter avec un maximum de détails cet équivalent de CV de garde d enfants. Vos domaines d expérience peuvent être les suivants: Please complete with your child care experience in as much detail as possible. Your areas of experience may include: Nanny, garde à plein temps de plus de 10 jours consécutifs Babysitting, garde ponctuelle Day care center, centre aéré Teacher, si vous avez enseigner professionnelement à des enfants Younger family member, garde d enfants de votre famille Au pair, si vous l avez déjà été Summer camp, colonies de vacances Tutoring, soutient scolaire Domaine d expérience Areas of expérience De à. Dates Age des enfants Ages of children Fréquence de garde Frequency of care

EXPERIENCE AVEC : ACCEPTEZ VOUS LA GARDE DE : EXPERIENCE WITH AGE GROUPS: 3 MOIS - 2 ANS (3 MONTHS 2 YEARS OLD) 2-6 ANS (2 6 YEARS OLD) 6ANS ET PLUS (6 + years) ENFANT HANDICAPES (Children with disabilities) WILLING TO TAKE CARE OF AGE GROUPS: SAVEZ-VOUS? CAN YOU? PREPAREZ UN BIBERON OUI NON CHANGER UNE COUCHE OUI NON PREPARE A BABY S BOTTLE CHANGE A NAPPY DONNER LE BIBERON OUI NON NOURRIR UN ENFANT A LA CUILLERE OUI NON FEED A BABY WITH A BOTTLE FEED A BABY WITH A SPOON DONNER LE BAIN A 0-12 MOIS OUI NON DONNER LE BAIN A UN 13-24 MOIS OUI NON BATH A 0-12 MONTHS OLD BATH A 13-24 MONTHS OLD AUTRES CERTIFICATS OBTENUS EN RELATION AVEC LES ENFANTS (PREMIER SECOURS, ANIMATEUR)... HAVE YOU HAVE ANY DIPLOMAS WHICH MAY BE USEFUL WHILE CARING FOR CHILDREN (FIRST AID, YOUTH LEADER ) Divers HOBBIES : MUSIQUE, SPORT, DIVERS... INTERESTS : MUSIC, SPORTS, LECTURE, ETC.... DECRIVEZ VOTRE PERSONALITE... HOW WOULD YOU DESCRIBE YOUR PERSONALITY?...... AVEZ-VOUS DEJA VOYAGE? SI OUI, PRECISEZ... HAVE YOU EVER TRAVELLED? GIVE DETAILS... FAITES UN RESUME DE VOTRE EXPERIENCE PROFESSIONNELLE ET DE VOTRE PLAN DE CARRIERE POUR L AVENIR - GIVE A BRIEF SUMMARY OF YOUR WORK EXPERIENCE AND PLANS FOR YOUR FUTURE CAREER...... DONNER NOUS LA RAISON PRINCIPALE POUR LAQUELLE VOUS VOUDREZ RETOURNER CHEZ VOUS APRES VOS SEJOUR AU PAIR PLEASE PROVIDE US WITH THE MAIN REASON WHY YOU WOULD LIKE TO COME BACK TO YOUR HOME COUNTRY AFTER YOUR YEAR AS AN AU PAIR...

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Votre Placement ACCEPTEZ-VOUS / WOULD YOU ACCEPT UNE MERE SEULE UN PERE SEUL A SINGLE MOTHER A SINGLE FATHER ACCEPTEZ VOUS UNE FAMILLE D UNE RELIGION DIFFERENTE OUI NON WOULD YOU ACCEPT A FAMILY FROM A DIFFERENT RELIGION SI NON PRECISER LESQELLES ET POURQUOI...... IF NOT PLEASE SPECIFY WHICH RELIGION AND WHY DE COMBIEN D ENFANTS ACCEPTERIEZ-VOUS LA GARDE?... HOW MANY CHILDREN WOULD YOU LIKE TO CARE FOR? ACCCEPTEZ VOUS UN PLACEMENT / WOULD YOU ACCEPT TO BE PLACED EN CAMPAGNE / IN THE COUNTRYSIDE OUI NON UN VILLAGE / IN A VILLAGE OUI NON PETITE VILLE / SMALL TOWN OUI NON GRANDE VILLE / LARGE TOWN OUI NON Un placement en campagne ou village serait soumis à la mise à disposition d une voiture / A placement in the countryside or a village would mean that you would have use of a car. SAVEZ-VOUS / CAN YOU: CUISINER / COOK OUI NON REPASSER / IRON OUI NON NAGER / SWIM OUI NON AIMEZ-VOUS LES ANIMAUX... SAVEZ-VOUS MONTER A CHEVAL... DO YOU LIKE ANIMALS? CAN YOU RIDE A HORSE FUMEZ VOUS... COMBIEN DE CIGARETTES PAR JOUR... DO YOU SMOKE HOW MANY CIGARETTES DO YOU SMOKE PER DAY SI OUI, MERCI DE CERTIFIER SUR L HONNEUR DE NE PAS FUMER EN PRESENCE DES ENFANTS NI DANS LA MAISON IF YOU DO SMOKE, WOULD YOU ACCEPT TO CERTIFIE THAT YOU WOULD NOT SMOKE WHEN RESPONSIBLE FOR THE CHILDREN OR IN YOUR HOST FAMILY S HOUSE OUI NON QUELLES SONT VOS QUATRE MOTIVATIONS PRINCIPALES POUR ETRE AU PAIR GIVE THE MAIN FOUR REASONS WHY YOU WOULD LIKE TO BE AN AU PAIR 1.... 2.... 3.... 4.... NOM ET ADRESSE DE VOS PARENTS... NAME AND ADDRESS OF YOUR PARENTS... TEL... Email :... PERSONNE A CONTACTER EN CAS D URGENCE... TEL... PERSON TO CONTACT IN AN EMERGENCY COMMENT AVEZ VOUS CONNU L AGENCE... HOW DID YOU HEAR ABOUT APITU

JE DECLARE LES INFORMATIONS PORTEES CI-DESSUS EXACTES ET COMPLETES - I DECLARE THAT THE ABOVE INFORMATION IS EXACT AND COMPLETE DATE... SIGNATURE... AU-PAIR IN FRANCE: AGREEMENT This letter of agreement is between Au-Pair in FRANCE, an Au-Pair Placement Agency herein referred to as APITU., and (Print name)... As a participant in the Au Pair in France programme, I agree to the terms and conditions set forth below. I agree: 1. I will carry out my child care and other responsibilities to the host family to the best of my ability and with due respect and will take full advantage of the educational and cultural opportunities in my community in accordance with the rules and guidelines set out in the brochure. 2. I am responsible for up to 30 hours of childcare per week plus 2 evenings babysitting. I will receive one week of vacation for a six-month stay and two weeks for a one year stay. 3. I will not accept any form of paid employment during my stay other than within my duties as an au pair with my host family. I agree to the weekly pocket money and will not incur any personal debts that cannot be covered by this amount. 4. The laws of my host country are very strict regarding drug abuse and vehicle usage. Disregarding these laws will result in my immediate repatriation at my own expense. I will abide by the house rules preordained by my host family, including those regarding smoking and vehicle usage. If a dispute arises, my Community Counselor will assist in determining what is «reasonable». 5. In case of problems with my placement, the Community Counselor will recommend and facilitate reassignment, repatriation or withdrawal for my host family and me. I agree to remain resident as an au pair with my host family for at least two weeks or until the situation is resolved, whichever comes first. 6. I will follow all instructions regarding travel, medical certificate, orientation and I will carefully read all materials sent or given to me. 7. Decisions regarding acceptance into the Au Pair in France programme, withdrawal / replacement and repatriation are at the sole discretion and authority of Au Pair in France. 8. I am responsible for transportation expenses to my host family and back to my country of origin. 9. I will cooperate fully with those supervising the program on my behalf for Apitu and I agree to abide by any reasonable instructions they may give me. 10. I understand failing to provide full and accurate responses to the questions asked in this application, and on all ancillary documents are grounds for my application to the programme to be rejected. I understand my application and contents therein cannot be returned to me. 11. I hereby warrant the information I have given in the application completed by me is accurate and contains no omissions and I agree to perform my duties as an au pair to the best of my ability and indemnify Apitu, their staff, agents and organizations affiliated with them against any loss or damage suffered by any of them or any claims made against any of them as a result of any breach or negligence by me during my participation in the programme. 12. I hereby agree Apitu or their affiliates or agents may without liability or expense to themselves take whatever action they deem appropriate with regard to my health and safety and may place me in the hospital for medical services and treatment, or if no hospital is available, may place me in the hands of a local medical doctor for treatment. 13. I acknowledge and agree to release the Apitu Agency, Au Pair in France, its Board of Directors, employees, agents and the host families from responsibility for any events beyond its control without limitation acts of God or government restrictions that may interfere with or preclude operation of the Au Pair in France program. 14. I further release Au Pair in France, Apitu, its subsidiaries or divisions, their officers, employees and agents from all claims for any personal injury, property damage or other loss or expense which I might suffer due to the act of a host family member of the guest or agent of a host family. 15. Refund policy. The application fee is not refundable under any circumstances. I confirm I have read the Au Pair in France brochure and agree its terms shall be incorporated into this agreement as if they were set out herein in full. Signature: Date and Place:

CERTIFICAT MEDICAL MEDICAL REPORT / Arztliche Bescheinigung Nous certifions que This is to certify that / Hiermit wird bestätigt dass Né(e) / Born / Geboren am / / est en bonne santé et qu un examen clinique ordinaire montre des conditions normales sans symptômes de maladie is in general good health and that an ordinary clinical examination shows normal conditions with no definite symptoms of illness bei guter Gesundheit ist, und dass eine generelle medizinische Untersuchung normale Befunde zeigt, und dass keinerlei Symptome noch Zeichen von Krankheit zu finden sind. date/date/datum lieu/place/ort Signature du docteur / signature of the doctor / Unterschrift des Arztes

Référence de Garde d enfants Nom - Prénom de la candidate :... Renseignements relatifs à la personne complétant ce formulaire Nom Prénom... Adresse... Téléphone (journée)... Téléphone (soirée). Portable. Parlez-vous anglais? Oui Non Quelle est la meilleure heure pour vous contacter?... Êtes-vous un parent de la candidate? Oui Non (Un parent ne peut compléter cette référence) Depuis combien de temps connaissez-vous la candidate?..comment l avez-vous connue? Combien de temps l avez-vous employée? De.....A. A quelle fréquence la candidate a-t-elle gardé vos enfants? (Quotidiennement, 1 fois par semaine, plusieurs fois par semaine)... De combien d enfants la candidate était-elle responsable?... Merci de donner un descriptif complet de ses tâches et responsabilités...... La candidate a-t-elle vécu avec votre famille? Si oui, combien de temps?... Quel âge avaient vos enfants quand elle a commencé à travailler pour vous.... Age de vos enfants aujourd hui... Décrivez toute autre compétence particulière dont la candidate a su faire preuve auprès de vos enfants...... Merci de donner votre opinion sur ses capacités à faire face au stress, choc culturel, etc....... Merci de noter les qualités de la candidate dans les domaines suivants (1=médiocre, 2= moyenne, 3=Satisfaisant, 4=Bon, 5=Excellent) Compassion Note Sens des responsabilités / Maturité Note Amour pour les enfants Note Patience Note Indépendance Note Capacité à travailler avec des adultes Note Compréhension des enfants Note Flexibilité Note Recommanderiez-vous la candidate pour un placement au pair? Merci de donner vos raisons en détails...... Signature Date

Childcare Reference Name of Applicant:... To be completed by childcare referee Name of Referee... Address... Telephone (day)... Telephone (evening)...... Mobile...... Do you speak English?... Are you related to the applicant?...yes No How long have you known the applicant?. How do you know the applicant? How long has the applicant been employed/ cared for your children? From. To.... How often does/did the applicant care for your children? (Daily, once a week, several times a week)... How many children was the applicant responsible for?...... Please give a full account of the applicant s duties...... Has the applicant lived with your family? If so, for how long?... Please list the ages of the children at the time the applicant cared for them.... Age of children now... Describe any special skills and abilities the applicant showed... Please give your opinion of the applicant s ability to handle new situations and possible stress, culture shock, etc....... Please rate the applicant s qualities in the following areas (1=poor, 2= below average, 3=satisfactory, 4=good, 5=excellent) Warmth- Compassion Note Responsibility / Maturity Note Love of children Note Patience Note Independence Note Ability to work with adults Note Understanding the children s needs Note Flexibility Note Would you recommend the applicant for placement as an au pair? Please give your reasons in as much detail as possible...... Signature Date

Référence de Caractère Nom - Prénom de la candidate :... Renseignements relatifs à la personne complétant ce formulaire Nom Prénom... Adresse... Téléphone (journée)... Téléphone (soirée). Portable... Parlez-vous anglais? Oui Non Quelle est la meilleure heure pour vous contacter?......... Etes-vous un parent de la candidate? Oui Non Depuis combien de temps connaissez-vous la candidate?.comment l avez-vous connue?. Décrivez la personnalité et le caractère de la candidate :... Merci de noter les qualités de la candidate dans les domaines suivants (1=médiocre, 2= moyenne, 3=Satisfaisant, 4=Bon, 5=Excellent) Honnêteté Note Sens des responsabilités / Maturité Note Amour pour les enfants Note Patience Note Indépendance Note Ponctualité Note Sens de la communication Note Flexibilité Note Recommanderiez-vous la candidate pour un placement au pair? Merci de donner vos raisons en détails Renseignements complémentaires sur la candidate qui pourraient être utiles à une famille d accueil potentielle Signature Date

Character Reference Name of Applicant:... To be completed by character referee Name of Referee... Address... Telephone (day)... Telephone (evening)...... Mobile.... Do you speak English?... Are you related to the applicant? Yes No How long have you known the applicant?... How do you know the applicant?... How would you describe the applicant s personality and character?... Please rate the applicant s qualities in the following areas (1=poor, 2= below average, 3=satisfactory, 4=good, 5=excellent) Honesty Note Responsibility / Maturity Note Love of Children Note Patience Note Independence Note Punctuality Note Communication skills Note Flexibility Note Would you recommend the applicant for placement as an au pair? Please give your reasons in as much detail as possible......... Please provide any additional information about the applicant which would be helpful to a prospective family...... Signature Date

EXAMPLE OF PLAN FOR LETTER OF MOTIVATION / EXEMPLE DE PLAN POUR LA LETTRE DE MOTIVATION Note: Remember that this letter is addressed to parents who have the task of selecting a candidate who will take care of what they hold most precious in the world: their children. This letter, like photos, is the most personal element of your case. It is from reading this letter that the family will know if you fit their lifestyle and therefore whether you will integrate easily. Feel free to develop what you feel is important and especially be honest but not modest! Chère famille, Introduce yourself considering that they know nothing about you Je m appelle Stephanie, j ai XX ans, mon anniversaire c est le xxx, et je suis xxx J étudie xxx (a xxx). J ai vécu tout ma vie en XXX, et j ai étudié dans un XXX XXX c est pour ça que le français est ma deuxième langue (après XXX, qui est ma langue maternelle). Cette année, j ai XXXXXXXX XXX des cours de français. J ai XXX frères/sœurs : un de XXX ans, et un petit frère de XXXX ans. Tous les XXXX nous habitons avec mes parents: ma mère est artiste peintre, elle donne des cours de peinture aux enfants chez nous et elle fait de la danse classique; mon père est XXXX et maintenant il travaille pour le XXX. J ai connu le programme Au Pair grâce à XXX. J adore les enfants, et dans plusieurs occasions j ai gardé des enfants de différents âges : J ai gardé mon petit frère quand il était petit, mes cousins et des enfants des amis de mes parents, et d autres en différents occasions. Je suis très bonne pour les garder car je suis une personne très responsable et patiente. J aime faire du sport, spécialement, j aime faire XXXX. Je suis une personne très calme, je ne fume pas et j aime bien voyager beaucoup. J aime être avec mes amis et ma famille et lorsque j ai le temps j aime lire, regarder la T.V et écouter de la musique. Je veux interrompre mes études pendant six mois ou un an pour aller comme au-pair en France. Je cherche à voyager et à apprendre d autres cultures différentes de la mienne. J adore votre langue et votre culture, pour moi ça serait génial de pouvoir connaître votre pays et d améliorer mon français. En échange, je serai ravie de vous aider avec vos enfants. Je vous remercie de me donner cette opportunité de réaliser mon rêve. Je suis sûre que ça ira très bien et que ce sera une expérience fabuleuse. Amicalement, Stephanie.

Nom : Prénom : Adresse : Téléphone : E-mail : Date de naissance : Age : Nationalité : CURRICULUM VITAE Photo Pas obligatoire / not mandatory EDUCATION Dates :.. Dates :. Expérience professionnelle Sample DO NOT COMPLETE! Dates :.. Dates :.. LANGUES Français :.. (Niveau) Anglais :. (Courant) HOBBIES et INTERETS