APPLICATION FORM / FORMULARIOS / DOSSIER D’INSCRIPTION · Angleterre/Inglaterra Ecosse/Escocia Irlande/Irlanda USA/EEUU Canada/Canadá Espagne/España France/Francia Allemagne/Alemania

1

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

2



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

3



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.

CF reference #2 in the file

4



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

5



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

Documents

APPLICATION FORM / FORMULARIOS / DOSSIER D’INSCRIPTION · Angleterre/Inglaterra Ecosse/Escocia Irlande/Irlanda USA/EEUU Canada/Canadá Espagne/España France/Francia Allemagne/Alemania