Find an Au Pair Form - Student State

Your name and surname*
Email*
Phone*
What area do you live in?*
Number of Children
Please enter a number from 1 to 6.
Child 1 Name
Child 1 Grade
Child 1 School
Child 2 Name
Child 2 Grade
Child 2 School
Child 3 Name
Child 3 Grade
Child 3 School
Child 4 Name
Child 4 Grade
Child 4 School
Child 5 Name
Child 5 Grade
Child 5 School
Child 6 Name
Child 6 Grade
Child 6 School
Days Required
- Monday
- Tuesday
- Wednesday
- Thursday
- Friday
- Saturday
- Sunday
Times: Monday
Times: Tuesday
Times: Wednesday
Times: Thursday
Times: Friday
Times: Saturday
Times: Sunday
Monthly Budget
Male / Female Preference
Additional Information
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Email
This field is for validation purposes and should be left unchanged.