Email this Page Print this Page

Host Family Confirmation Form

Congratulations on matching with your au pair. Please provide the following information so that we can process the necessary paperwork for your au pair’s arrival.

All information is required

Host Family Parent First Name *

Host Family Last Name *

Address Line 1 *

Address Line 2

ZIP Code *

Au Pair Last Name *

Au Pair First Name *

Country *

Mutually agreed upon au pair arrival date to New York *

Dates of your inteview with this au pair (this is required by the U.S. Department of State) - Interview Date 1 *

Dates of your inteview with this au pair (this is required by the U.S. Department of State) - Interview Date 2 *

Questions? Contact Us

Host Family Confirmation Form