Au Pair in Spain | Application Form

Au Pair in Spain | Application Form
Name & Surname*
Which programme are interested on? You could apply to both*

Au Pair in SpainAu Pair Plus in Spain
Region prefered

Town/CitySuburbsCountrysideOtro
Are you flexible with region?

YesNo
First date available to start*
Last date available to start*
Last date available to stay in Spain
Contact Information
Full Address*

Line 1

Line 2

City/TownCountry

Post Code
Correo Electronico*
johnsmith@example.com
Skype ID*
Mobile Number*

Country CodePhone Number

Educational Background
Attended school/College
School/College name / How many years? / Type of graduation
Attended school/College
School/College name / How many years? / Type of graduation
Attended school/College
School/College name / How many years? / Type of graduation
Your current occupation
If you are currently employed what is your profession
Current employer, company and position, if any

Childcare Experience
Please, indicate the age groups you have experience with*

Newborn9-24 months2-5 years5-10 yearsOlder than 10
Do you have experience with children with special needs or handicapped?*

YesNo
If yes, please explain
Any further information that would assist a family in deciding to invite you
Please, list details of your childcare experience
Name & Age of children/Type of childcare/Start/end (Aprox. dates)Frequency (How often?)/Activities

In case of emergencies, please call
Contact 1
Full Name*
Mobile Number*

Country CodePhone Number
Relationship to you*
Contact 2
Full Name*
Mobile Number*

Country CodePhone Number
Relationship to you*
Would you like Club RCI to book a Spanish course in Madrid for you?*

YesNo
If yes, how many weeks?
Health & Travel Insurance
Non-EU citizens (compulsory)

Private health and accident insurance is COMPULSORY for Non-EU citizens. We provide you a special flat rate of 20€/week with Guard me (multirisk).

CHECK CONDITIONS HERE
How many weeks?*
EU citizens (optional)

We recommend EU citizens to get private insurance. We could provide you a multirisk Guard Me at a flat rate of 13€/week. Would you like us to get you insurance to cover your stay in Spain?

CHECK CONDITIONS HERE
YesNo
If yes, how many weeks?

Declaración | Disclaimer
Confirmo que la información dada es veraz y estoy de acuerdo con las condiciones del programa Au Pair in Spain de Club RCI, de las cuales he sido debidamente informado para participar en el programa.

I herewith confirm the given information is true to the best of my knowledge and I agree with the terms of business of Club RCI; I´ve been properly informed about the conditions to join the Au Pair in Spain programme.

By submitting this form you are agreeing to our privacy policy.
Full Name*

NameSurname
Passport/ID Number*
Signature*
Date
Where have you heard from Club RCI?*

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