APPLICATION FORM / FORMULARIOS / DOSSIER D’INSCRIPTION · Angleterre/Inglaterra Ecosse/Escocia...
Transcript of APPLICATION FORM / FORMULARIOS / DOSSIER D’INSCRIPTION · Angleterre/Inglaterra Ecosse/Escocia...
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Avda. Maria Cristina º1 – 46001 – Valencia (España)
Tel: +34.670.461.477 / +34.960.052.901 www.magaupair.com l [email protected]
APPLICATION FORM / FORMULARIOS / DOSSIER D’INSCRIPTION:
. Please reply the document in the language of the country where you wish to travel. . Por favor, rellene el documento en el idioma del país al que deseas viajar. . Remplis s’il te plaît, le formulaire dans la langue du pays où tu souhaites séjourner.
Host country – País de acogida – Pays d’accueil
England Scotland Ireland United States Canada
Spain France Germany Belgium Switzerland
Netherlands Italy New Zealand Austria Other
About your placement – Referente a su emplazamiento – Concernant ton placement
Area preferred Zona preferida? / Zone
préferée?
Would you like to
live in: Deseas vivir en/ souhaites habiter
city small town ciudad – ville – pequeña ciudad – petite ville
village it doesn’t mind pueblo – village – no importa – peu importe
If we can’t place you in this area, would you accept another one? Aceptarías otra zona que te podamos ofrecer/ Accepterais-tu un autre endroit que nous puissions te proposer?
Yes No
Why :
First date available to start work Fecha en la que desaría llegar/Au plus tôt
Last date available to start work Fecha más tardía en la que puedes empezar/Au plus tard
Length of stay required Duración de estancia/Durée du séjour
I can be also interested in this program También me puede interesar este programa – Ce programme peut également m’intéresser
How do you hear about Mag’Au Pair (www.magaupair.com)?
Cómo has conocido a Mag’Au Pair – Comment as-tu
connu à Mag’Au Pair
Au Pair Au Pair Plus Mother help/Nanny Housekeeper Living with elderly work and travel
Angleterre/Inglaterra Ecosse/Escocia Irlande/Irlanda USA/EEUU Canada/Canadá Espagne/España France/Francia Allemagne/Alemania Belgique/Bélgica Suisse/Suiza
Pays-Bas/Países Bajos Italie/Italia Nouvelle Zélande/Nueva Zelanda Autriche/Austria Autre/Otro
I would loveLondon or around
Yes but I prefer the city of London
27th of September
October
Until August
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Avda. Maria Cristina º1 – 46001 – Valencia (España)
Tel: +34.670.461.477 / +34.960.052.901 www.magaupair.com l [email protected]
Personal details – Datos personales – Données personnelles Name, Surname
Nombre, apellidos nom, prénom
Nationality
nacionalidad/nationalité
Date of birth
Fecha naciemiento / Date naissance
Male Female
Age
Adress -
Dirección - Adresse
ID card nº - DNI
Skype (para entrevista)
Town / city Ciudad - ville Post Code
Codigo postal - CP Country - país –pays
Phone numbers Núm. Tfo – Nº de Tel
Home phone No
Mobile phone No
E.mail
About your family Sobre su familia – à propos de ta famille
Father’s occupation Mother’s occupation Nº of brothers/sisters + ages Edad de tus hermanos/âge de tes frères
Driving Licence Carnet de conducir – Permis de conduire
Yes No Since: desde - depuis
Are you willing to drive a car? Estás dispuesta a conducir – Acceptes-tu de
conduire
Yes No
Driving frequency Frecuencia – Fréquence
Once a month Once a week On daily basis una vez x mes – una vez x semana – diariamente
une fois x mois – une fois par semaine – au quotidien
Religion Do you practice? Yes No Would you agree to live with a family of another religion or race? Aceptarías vivir con una familia de otra religión u otra raza acceptes-tu de vivre avec une famille d’autre race ou d’autre religion
Yes No Would you accept to live with a single parent? Aceptarías vivir con una familia monoparental Accepteriez-vous de vivre avec une famille monoparentale
Mother Yes No
Father Yes No
Have you ever been au pair? Has sido ya alguna vez au pair/as-tu déjà été au pair Yes No If yes, where and how long time? En caso afirmativo, donde y cuanto tiempo/si oui, où et combien de temps? Do you wish to attend language school Deseas ir a clase de idiomas /souhaitez-vous vous inscrire à des cours de langue
Yes No First aid skills
Primeros auxilios – Brevet de secourisme Swimming skills
Sabes nadar – Sais-tu nager Yes, certified (diploma included) No Good Beginner None
Hobbies – Ocios – Loisirs Name your interests and hobbies? Sus intereses y ocios – ses centres d’intérêts et loisirs
Do you play any instruments? Toca algún instrumento – joues-tu d’un instrument What type of sports do you do? Qué deportes practicas – quel sport pratiques-tu Do you have any specials talents? Tienes algún talento – As-tu un talent spécial
EMERGENCY CONTACT – CONTACTO DE EMERGENCIA – CONTACT EN CAS D’URGENCE Name
Nombre/prénom
Relationship to you
parentesco/lien parenté
Home phone Nº Mobile phone Nª Work phone Nº or Email
Joana Pastor Spanish 2716.07.1987
San Cristobal 27 20848047L
Spain46740Carcaixent
joana_pastor
[email protected]+34665132581+34962432405
School Teacher Businesswoman 3 sisters: 2 of 30, and one 162011
4 months
Design, read and draw
No
Yoga
Draw & design
Remei Mother
+34962012950+34605256572+34962432405
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Avda. Maria Cristina º1 – 46001 – Valencia (España)
Tel: +34.670.461.477 / +34.960.052.901 www.magaupair.com l [email protected]
Chidlcare experience – Experiencia en el cuidado de niños – Expérience avec les enfants
Family / institute name Familia – Instituto / famille - Institution
Nº of
children nº niños -enfants
Age range of children
edad niños – âge enfants
Hours per week
h/sem Start date End date Reference
included
Yes No
Yes No
Yes No
Childcare Activities actividades con los niños – activités avec les enfants
Specify Experience. Give examples with what she did in each childcare activities
Describa tu experiencia dando ejemplo – Décris ton expérience en donnant des exemples Changing diapers cambiar pañales – changer des couches
Yes No
Feeding babies Darle de comer a un bebé – donner à manger à un bebé
Yes No
Bathing babies Bañar a un bebé – donner le bain à un bebé
Yes No
Playing with children Jugar con los niños – jouer avec les enfants
Yes No
Cooking for children Cocinar par los niños – cuisiner pour les enfants
Yes No
Feeding the children Dar de comer a los niños – donner à manger aux enfants
Yes No
Getting children up and dressed Despertar,vestir a los niños – réveiller,habiller les enfants
Yes No
Bath the children Bañar a los niños – donner le bain aux enfants
Yes No
Washing, ironing children’s clothes - Lavar, planchar ropa de los niños – Laver et repasser linge des enfants
Yes No
Making the beds of the children Hacer la cama de los niños – Faire le lit des enfants
Yes No
Bringing children to bed Llevar los niños a dormir – Amener les
enfants au lit Yes No
Picking the children up from school – reocger los niños del cole – récupérer les enfant à l’école
Yes No
Do you have experience with babies? – Tienes experiencia con bebés ? As-tu de l’expérience avec des bébñes ?
yes no Details:
Would you consider a family with babies? Considerarías una familia con bebés ? Accepterais-tu une famille avec bebés ?
yes no
* In some cases, the mum is at home, so you won’t have the sole charge of the baby.
Giner Family 3 3 - 6 20 July October
I like playing with children , because in my house we have always been surrounded by them
I cook lunch and dinner.
I gave food to the three children at a timeDuring my experience with children I had to take care of the children Bath , lift them out of bed , dressing to go to school and take them to school
I have lived away from home for many time, and I taught iron my own clothes.
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Avda. Maria Cristina º1 – 46001 – Valencia (España)
Tel: +34.670.461.477 / +34.960.052.901 www.magaupair.com l [email protected]
Housework experience – Experiencia en tareas domésticas – Expérience en tâches domestiques
Household working experience ¿ Tienes experiencia? As-tu de l’expérience?
Are you willing to do following household duties? – Estas dispuesta a? Acceptes-tu de?
Specify Experience. Give examples with what you have done in each household activities Describa tu experiencia dando ejemplo – Décris ton expérience en donnant des exemples
Ironing clothes Planchar - Repasser
Yes No Yes No
Washing and folding clothes Lavar, tender ropa – Laver, étendre du linge
Yes No Yes No
Vacuuming Pasar la aspiradora – Passer l’aspirateur
Yes No Yes No
Picking up after children Ordenar detrás de los niños – Ranger derrière les enfants
Yes No Yes No
Cooking Cocinar – cuisiner
Yes No Yes No
Take care of pets Cuidar mascotas – Prendre soin d’un animal
Yes No Yes No
Language knowledge – Conocimiento linguístico – Connaissance lingüistique
English Good Intermediate Basic How long studied
Spanish Good Intermediate Basic
German Good Intermediate Basic
French Good Intermediate Basic
Other Good Intermediate Basic
Education – Educación – Education
Education / course Name of institute Start year End year Diploma
Yes No
Yes No
Yes No
I have dogs since I am 1 year old
8 years old
Italian since 2 years
Bachelor of Fine Arts
Master in Design and IllustrationINTERSHIP- Accademia de Belle Arti di Bologna
2010
2013
20102009
2011
2005Universidad Politecnica de Valencia
Universidad Politecnica de Valencia
Accademia de Belle Arti di Bologna
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Avda. Maria Cristina º1 – 46001 – Valencia (España)
Tel: +34.670.461.477 / +34.960.052.901 www.magaupair.com l [email protected]
I, the undersigned, certify that all the information given above is true and I accept all the conditions of general rules of Mag’Au Pair / Yo, el abajo firmante, certifico que toda la información que he dado es verdadera y acepto las condiciones del reglamento general de Mag’Au Pair / Je certifie que les renseignements fournis ci dessus sont exacts et j’accepte les conditions du règlement général de Mag’Au Pair. Date: Name,surname: Nombre,apellidos/Nom,prénom
Health – Salud – Santé Specify
Have you got any illness? Padeces de alguna enfermedad/souffres-tu d’ une maladie
Yes No
Are you allergic to animals? Tienes alergia a los animales/es-tu allergiques aux animaux
Yes No
Could you live in a family with animals? Podrías vivir con animales/peux-tu vivre avec des animaux
Yes No
Are you allergic to anything else? Tienes otras alergias/as-tu d’autres allergies Yes No
Must you go on a diet? (Vegetarian or other…) sigue algún tipo de dieta/suis-tu un régime alimentaire
Yes No
Do you have any medical treatment? Sigues algún tratamiento médico/suis-tu un traitement médical
Yes No
Do you smoke? Eres fumadora? Fumes-tu?
Yes No
I accept a non-smoker position
Do you understand you are not allowed to smoke near the children Entiendes que no puedes fumar delante de los niños – Tu
comprends bien que tu ne dois pas fumer devant les enfants Yes No
Mag’ Au Pair Avda. Maria Cristina nº1 46001 – Valencia (ESPAÑA) www.magaupair.com [email protected] TEL (+0034).670.461.477 (+0034).960.052.901
Since I am small I have always lived with animals.
I do not like everything and but adapt to the norms of the family that will live
Joana Pastor01.09.2015
!Dear Family:!My name is Joana, I´m 27 years old and I live in carcaixent, a village 30 km from Valencia (Spain).!!I have just finished my University studies and I need a new experience and change in my life.!!I have studied Fine Arts in the Technical University of Valencia . Speciality of graphic design!!My hobbies are: reading books (intrigue, detective story, romance…), playing table games, taking a walk on the beach, going out with my friends, watching classic films…!!I have been living away from home so I can deal with housework, any kind of it ironing, mopping, dusting,… I started to do them at home years ago when my parents were working. They have a shop. When I am in Carcaixent I also give them a hand with the shop.!!!I love dogs. It is my favorite animal since I was a child, really I like all of them.!!Besides I have worked as a salesgirl in a supermarket, my tasks were: open and close the establishment, place the articles on the shelf, general cleaning, service to customer and cash.!!I have worked as a nanny with children a few times. My tasks were: Picking the children up from school, playing with them, giving them their snack, helping them to do their homework, put them to bed.!!I have always got on well with the children, I enjoy playing and talking with them, I try to be their best friend.!!My main aim is living a period out of my country, to know new places, new cultures and improve the language, I am very curious about design so this will give me the opportunity to study the design in your country, visit some museums, enroll on a course of English, taste your gastronomy, know your habits and be part of them.!!I always like work with children. When I have worked with children, I have felt really comfortable.!!I consider myself a well-mannered, calm, gentle, pleasant, responsible girl. I usually help my parents at home and I have lived 5 years away from home so I am independent but at the same time I have shared my space, living together with another people.!! I am a good teacher; I will help your kids in their homework. I always have obtained good marks in all my subjects, but I am exceptional in arts, language and design.!!I´m sure that the experience will be very good, I am looking forward to meeting you soon.!!Yours sincerely.!!Joana Pastor