Au pair Application Unit

Au pair Application Questionnaire

Be informed that we have received your details from Mason Blake, regarding a
pending

job offer as Au pair/nanny to a 5year old. Kindly fill in the form below detailed
information

as required for assessment to enable us compile your requirement checklist as well

as

job contract letter.

NOTE: Information provided on this form must be valid, very viable and not
falsified

as traces of ingenuity will dismiss your application.

FILL THE FORM BELOW USING BLOCK LETTERS.

Name:
CAROLYN JANE ABENOJA

Nationality: Date of birth: Sex:

FILIPINO 01/10/94. F

Marital Status: Current Address:

SINGLE. DUBAI,UNITED ARAB AND EMIRATES

Tick the boxes bellow in affirmation.

Do you smoke? YES NO✔

Have you been to UK before? YES NO✔

Will you like to be registered for English classes? YES ✔ NO

MAYBE

Can you swim? YES ✔ NO

In the event of Au pair application, the Au pair will be required to prove that
he/she is

capable to meet the necessary financial status for entry into the United Kingdom,
as

well as Au pair/ Care giver financial status endorsement.

I will be able to meet up with the necessary financial requirements in the course
of my application.

Disclaimer: Information as found on this form is not falsified but original

and verifiable, as I will be held responsible if found wanting.

Surname: ABENOJA First Name: CAROLYN JANE

Other Names:

Mobile Number: Travel Date:

Duration of stay
+971525946411 MARCH 20,2021. 2 YRS
Sign: Date: Time:
C j/ Abenoja DECEMBER 21,2020 UAE TIME 2:54PM