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Host Family Application.
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| 1.General Information | ||
| Host Mother | Host Father | |
| Currently Employed? | Housewife | Businessman |
| First Name | Yujiao | Quan |
| Last Name | Song | Qu |
| English Name | ||
| Age | ||
| City | Qingdao | |
| Province | Shandong | |
| Language | Chinese | |
| Do host parents smoke？ By whom/How much? | ||
| Yes, hostdad smokes. | ||
| Do you allow your Au Pair to smoke? | ||
| No | ||
| How do you know different cultures？ （ Eg： go abroad or did a foreigner stay with you？ ） If yes, please describe it in detail. | ||
| We don’t know much about different cultures |
| Children Information | |||
| Child 1 | Child 2 | Child 3 | |
| Name | Qu zheng | Qu hao | |
| English | |||
| Gender | Male | Female | |
| Birth Date | 2004.05 | 2010.05 | |
| Education Level | Primary school | Kindergarten | |
| School Hours | |||
| Hobbies | Sports | Drawing | |
| Language | Chinese | Chinese | |
| Remarks/Notes |
| Other Family Members Information | ||||
| Name | ||||
| Gender | ||||
| Age | ||||
| Relationship | ||||
| Occupation | ||||
| Language | ||||
| What language other than Chinese can be spoken by your family member? | ||||
| Name | ||||
| Language | ||||
| Level |
| 2.Diet and Health of Your Family | |
| Is your family good in healthy? | Yes |
| Please explain | |
| Has anyone in your family been in hospital in the past 12 months or treated by drugs for a long time？ | No |
| Has your family ever needed treatment, counseling or hospitalization for a psychological or psychiatric condition? | No |
| Is there any disabled people in your family？ | No |
| Do you have dietary restrictions? | No |
| 3. Other Information | |
| Religious Affiliation(s) | No |
| Would you mind if your Au Pair is of another religion? | |
| Which of the following free time activities or hobbies do you like？ （ Please choose or fill out what activities do you do usually? ） | |
| 1. Movie, theater, concert. 2. Go shopping 3. Join cultural and artistic performances. What kind: __________________ 4. Library, museum. 5. Draw and calligraphy 6. Play outdoor sports. What kind: _hikking, fishing _____ 7. Church or other religious activities 8. Swim and fitness 9. Eat out 10. Watch performances 11.Have a party with relatives and friends Other interests______________________ Would you like your Au Pair to join you？ Yes | |
| Are there any pets in your family? | Yes, we have a dog (u can see him in the photo) |
| How many meals can you have with Au Pair every day？ | At least twice |
| Will your Au Pair have own bedroom and bathroom？ | Yes, she will have her own bedroom and shared bothroom with kids |
| How long can you help your Au Pair practice Chinese every day？ | More than 2hours a day |
| How often will you invite Au Pair to go out for a short trip? | Twice |
| Will you travel with Au Pair during this program? | It depends |
| What vacation expenses will your Au Pair be expected to pay? | She will need to pay for the flight ticket |
| Home Condition | |
| We have a 303 square meters two stories apartment with a little yard. | |
| Describe your neighborhood | |
| We live in a gated community. | |
| Since the primary goal of the Au Pair program is cultural exchange, please list opportunities in your community that your Au Pair may take advantage of (i.e, art, music, history, sightseeing, etc). | |
| The bus stop is just outside of the community. its very covenient to go all most everywhere. | |
| How will you teach or show the Chinese culture to your Au Pair? （ Eg: Chinese food, musical instruments, dancing, art, martial art or wei qi [ The game of go: a game played with black and white pieces on a board of 361 crosses.]） | |
| We are planing to take our daughter to some chinese tranditional instrument class. she can go with her and learn together. | |
| Please describe your family’s daily schedule. | |
| Monday to Friday The kids get up around 6: 30am they are going to school at 7am and come back home around 4pm The host dad get up around 7am and goes to work around 8: 30am | |
| How does your family spend the weekend? | |
| On Friday night, we normally have a small party with our neighbour. The kids have some extra class on Saturday morning. Saturday afternoon and Sunday, we are going outside. |
| 4.Home Information | |||
| Do you have a housekeeper or nanny? | Yes | Duties: laundry, clean the house | Time: 1pm to 5pm |
| Do you have a hourly worker ？ | Duties: | Time: | |
| Do you expect this to change with the arrival of your Au Pair? | No | ||
| How important is it to have your home clean and tidy? (1 Very Casual, 10 Meticulous) | 8, important |
| 5. Au Pair Preference | |
| Have you invited Au Pair before？ | If yes, please answer the following questions. |
| Where are they from？ | |
| No | |
| How long did they stay with you？ | |
| Reasons for leaving. | |
| Expected Program Duration | 12months |
| What do you want your Au Pair to do in your family? What’s your Au Pair’s duty? | |
| Take the kids to school and pick them up after school Encourage them to lean english and doing their homework. playing with them. It would be very nice if u can cook for us once or twice a week. so we can also learn your cultural. | |
| List other restrictions | |
| Bad habit | |
| How can you help Au Pair adjust herself/himself to the new way of life and Chinese culture as soon as possible？ | |
| Communicate | |
| How will you help your Au Pair to relief the homesick feeling? | |
| We will treat her as our own daughter and talk with her. | |
| How can you solve the trivial conflicts between you and Au Pair？ | |
| We think respect is more important than everything. |
| 6.Other Requirements For Your Au pair | |
| What gender do you prefer your Au Pair to be? | Female |
| Do you have any requirement for Au Pair’s skills. | Yes, hope she can play some instruments |
| What age do you prefer your Au Pair to be? | 18 to 29 |
| What nationality (ies) do you prefer? | None |
| Do you have any requirement for Au Pair’s foreign level？ | Speak fluently enlish |
| Do you have any requirement for Au Pair’s Chinese level？ | None |
| Do you have racial discrimination？ | No |
| What do you feel are the most important characteristics.of.a.successful.Au.Pair/Host family relationship? | 1.How well can she get on with my children？ 2.Whether can she adjust herself to the way of the host family’s life？ 3.Whether can her behavior produce a positive influence on my children？ |
| Why do you want to invite an Au.Pair？ | We want an aupair to improve our children’s English, expand their horizons and let them have a foreign sister, a good example. |
| List other qualifications | We hope the aupair is talktive girl and has patience |
| Letter to Au Pair |
| Dear au pair, Welcome to china and be a member of our family. we are a tranditional chinese family. im a housewife, my husband is a businessman. but he is not that busy. we have two children, one girl and one boy. the reason we would like to invite aupair is because we hope our children can learn some english and western cultural when they are still young. We are so glad that you will be a part of our family. We come from Qingdao, which is far away from your country. Have you ever heard of Qingdao beer？ It’s just from this city, so you will have chances to try Qingdao beer. We believe that you would be very happy when you are in Qingdao, because many interesting places can be found in this city. We hope that you will have a feeling of being at home. We are looking forward to your arrival. We would like to share something about our culture with you |
| Family Pictures |
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