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Your name: Email address: Aupair-number (Jobmatch): How old are you? (When is your birthday?) Tell us about your family and childhood How many brothers and/or sisters do you have? What do your parents do? Are you close to your family? Do you have a boyfriend? What kind of experience have you had with children? How do you discipline children? Have you had any problems? How much schooling have you had? What kind of jobs have you had? What responsibilities around your home do you have? What type of working and personal relationship would you like to have with your employer? family? What are you doing currently? How long have you been driving? Do you have a driver’s license? Do you have an International driver’s license? Any accidents? Why do you want to come to Holland and what do you want to do while you are here? What do you like to do in your free time? Do you find it easy to meet new people and make friends? Do you swim? If so, how well? Do you have any health problems? Are you taking any medication? Do you smoke and/or drink (please be honest)? Do you have any dietary restrictions (such as no red meat, allergies etc.)? Have you ever been arrested for any crime? If yes, please describe the situation. Have you ever been treated for depression or mental illness? If yes please describe the situation and treatment. Do you have any friends and/or family in Holland? How soon can you come over and how long do you plan to stay here? How can we reach you? - Telephone number (what is best time to reach you?) - Address - E-mail - Fax number Are you currently applying with other families (please be honest ;o))? Any other comments? Thank you VERY much for taking the time to answer all of our questions. Please do not hesitate to ask us any question whatsoever you might think of!