Wanderlust Exchange Au Pair Application Form

提示：此问卷发布者的文件上传空间已使用完，问卷无法提交，请联系问卷发布者！
Dear Au Pair candidate,
Please fill out the application form for the first step of your adventure to China! It takes about 10-15 minutes and the information will be only used for the family to get to know you.

IMPORTANT: Do not close the page until you finish the form, otherwise you will need to type in your information again.
*1.
Earliest arriving date
最早来华时间
*2.
Latest arriving date
最迟来华时间
*3.
Longest of Stay(3-12months) in China
在华时间

*4.
Basic Information
基本信息
First Name 名字
Last Name 姓
Full Name 全名
Male/Female 性别
Date of Birth (mm/dd/yyyy) 出生日期
Place of Birth 出生地
Nationality 国籍
Religion 宗教
Passport Number 护照号码
Married/Single/Divorced/ 婚姻状况
Height& Weight (cm& kg) 身高体重
Do you have a driving License(Yes/No) 你有驾照吗？
*5.
Family Information
家庭信息
Father’s name and occupation 父亲
Mother’s name and occupation 母亲
Home address 家庭住址
Postal code 邮政编码
Are you currently living with your parents? 是否和父母住在一起？
*6.
Do you have any siblings? (If yes, please specify relationship and age)
你有兄弟姐妹吗？
*7.
Contact Information
联系方式
Phone at home/work (National code+area code +number)
Mobile (National code+area code+number)
Email (essential)
How did you know about our program?
Skype (very important)
Wechat: (very important)
Emergency contact person’s cellphone number
Your relationship with the emergency contact person
The Best Time to Contact you?
Address of your current living
Postal Code
City&State (time difference uses)
*8.
Education Background 1 (From the highest degree)
教育背景
学位/专业Education (qualification/major)
校名School name
起始 Starting year
结束 Finishing year
9.
Education Background 2 (From the highest degree)
教育背景2
学位/专业Education (qualification/major)
校名School name
起始 Starting year
结束 Finishing year
*10.
Language
语言能力
Mother Tongue 母语
Chinese level 中文水平
Would you like to attend a language school to learn Mandarin? 你想参加中文课程吗？
Other languages (and level) 其他语言
*11.
Hobbies & Interests
兴趣爱好
Please describe your hobbies in details 请形容下你的兴趣爱好
Which sports do you like? 你喜欢什么运动？
*12.
Do you play any instruments?
你会弹奏乐器吗?
*13.
Do you have any experience with children?
你有照顾孩子的经验吗？
*14.
Childcare Experience 1 孩童看护经验1
Please describe your childcare experience in details
Range of children age 儿童年龄
Working period of time 工作时长
Job description 工作描述
15.
Childcare Experience 2 孩童看护经验 2
Please describe your childcare experience in details
Range of children age 儿童年龄
Working period of time 工作时长
Job description 工作描述
16.
Childcare Experience 3 孩童看护经验 3
Please describe your childcare experience in details
Range of children age 儿童年龄
Working period of time 工作时长
Job description 工作描述
*17.
What is your preferred range of children’s age?
你希望照顾多大年龄段的孩子？
*18.
Do you smoke? Would you mind the host family members smoking at home?
你吸烟吗？你介意你的寄宿家庭吸烟吗？
*19.
Do you have a preference of the host city/cities? If yes, are you open to other cities?
有偏向的城市吗？如果有，能接受其他城市吗？
*20.
Do you have any other requirements from the host family of China?
你对寄宿家庭有什么要求吗？
*21.
Do you swim?
你会游泳吗？
*22.
Do you like animals?
你喜欢动物吗？
*23.
Do you have any dietary restrictions?
你有什么忌口吗？
*24.
Do you have working experience?
你有工作经验吗
*25.
Work Experience 1 工作经验 1
Please describe your work experience in details
Name of working place 工作地点
Working period of time 工作时长
Job description 工作描述
26.
Work Experience 2 工作经验 2
Please describe your work experience in details
Name of working place 工作地点
Working period of time 工作时长
Job description 工作描述
*27.
Can you provide a Medical Certificate (not older than 6 months, we will also provide you a medical report form if needed)?
你可以提供健康证明吗？
*28.
Do you take medications regularly?
(If yes, please specify)
你有规律性用药吗？
*29.
Do you suffer from any allergies?
(If yes, please specify)
你有过敏源吗？
*30.
Are there any specific comments you would like doctors to know in an emergency situation?
(If yes, please specify) 有特殊医嘱吗
*31.
Have you been to China before? (If yes, please specify)
你之前有来过中国吗？
*32.
Why do you choose China as your destination?
为什么选择中国作为你的目的地？
*33.
What’s the main reason that you would like to be an au pair?
你想做互惠生的主要原因是什么？
*34.
What do you expect from the host family?
你对寄宿家庭有什么期望？
*35.
How are you going to spend your free time in China?
闲暇时间你打算在中国怎么度过？
*36.
When will you be available to talk with the host family by Wechat?
你什么时间方便和家庭面试？
*37.
Please attach ONE picture which shows the best of you!
*38.
Please write a letter to your future host family below.
给家庭的一封信

Dear Host Family,
 （at least 100 words）
loading...