Name(1): Cell: Email:
Name(2): Cell: Email:
Home Address:
Street: H.Tel
City: Province: Postal Code:
Closest Main Intersection: On Public transit ?: YesNoLimited
Is this Address: UrbanTownRural/Country
Name Date of Birth Sex Attending School
Social interests, activities, regular appointments, medical problems:
Languages spoken in Home: EnglishFrenchOther Languages
Do you prefer a non smoker?: YesNo Will you accept a social smoker?: YesNo
Do either parent work from home?: YesNo
Swimmer?: YesNo Do you have a swimming pool?: YesNo
Driver’s License Required?: YesNo Required to drive children?: YesNo
Car available? Daytime: YesNo Time off?: YesNo
Manuel or Automatic
CATEGORY OF HELP AU PAIR(25 – 35 hrs.)AU PAIR PLUS (35 + hrs./ week & housekeeping )
Work Schedule:
MonTueWedThrFriSatSun Split Shift :
Expected Start / Finish Times:
Total Hours / Week: Total break time daily :
Wages offered: Evening sitting in lieu of Rm.& Bd. :
Public transit pass: YesNo Occasional use of car: YesNo Other:
Bathroom PrivateShared
Newborn to 1yr1yr to 3yrs.3yrs. to 5yrs.5yrs. to 8yrs.8yrs. to 12yrs.TeenagersChange DiapersToilet TrainLaundryChildren’s BedsClean BedroomsChildren’s BathroomDrive to SchoolWalk to SchoolTake to ActivitiesAssist with Homework
Any Special Needs
VACUUMING: Child Related Areas OnlyThroughout Minus Mstr.BdrmThroughout
DUSTING: Child Related Areas OnlyThroughout Minus Mstr.BdrmThroughout
SPONGE MOPPING FLOORS: KitchenMain BathroomHallsOther
Children's Breakfast Children's Lunch
Dinner: PrepareAssistMeal Planning by ParentsClean Up
LAUNDRY: FamilyChildren’s onlyHousehold Bed / Bath LinenChildren Bed / Bath Linen
Pet Care: Dog(s)Cat(s) Other
FeedWalk Other
Oven/StoveMicrowaveDishwasherTrash CompactorWashing MachineDryerVacuum CleanerWall Vacuum
Involvement in family life
Mealtimes with FamilyJoin in family activitiesBe included in family holidays,Vegetarian accepted
Household Restrictions :
Prior Live – In experience ? : Was it a good experience ?
If possible, please provide name& contact info of previous nannies so that your new candidate can speak with them.
Name: Yrs of Stay Tel / or e-mail:
Other Comments regarding the position of the potential AuPair / Au Pair Plus are most welcome:
Are you a previous TPL client?: If so, when?:

On receipt of your request or telephone call, a member of our experienced placement team will contact you to discuss the options available to you. Our applicants are mainly recruited by our well established partner agencies overseas who reflect the high standards we offer each client. All candidates are vetted to ensure verification of their application form, references are checked and medical and Police Clearance Certificates are supplied. The majority of our AuPairs have a very good command of English with good childcare skills.

Trafalgar Personnel Limited does NOT charge a Registration Fee to families. Only upon confirmation of a placement are Host Families required to pay our agency fee according to the schedule noted below.

Au Pair Placement Fees:

$150.00 / month or part thereof to a Maximum $1,500.00 / 12 month period , plus HST.

Payment by Cheque, e-transfer or cash..We do NOT accept credit or Debit card payments. Receipts will be issued for Child Tax Credit purposes at the beginning of the next calendar year..

Fees are valid 15 days and subject to change.

Payment of fees for the total # of months booked, is due and payable in advance :

3 – 5 months Placement :

- Payment in full upon confirmation of placement.

6 – 12 months Placement :

- $750.00 + HST Deposit upon confirmation of placement
- Balance owing is payable upon notification of flight details and PRIOR to the Applicant’s arrival in Canada, OR for those already in Canada, prior to their moving into the employer’s home , or commencement of employment - whichever comes first.

Although flexibility is required from both parties, Host /Employer families are expected to follow the general guidelines of the Job Offer made and GUARANTEE a minimum NET Wage of $200.00 NET / week plus a transit pass for any Au Pair / AuPair Plus placed through Trafalgar Personnel. In Ontario, wages will be based on the wage guideline set by HRSDC for LCP Caregivers and may increase in 2014. There is a possible option to reduce Room & Board charges in lieu of evening babysitting once week.

Should employment of the AuPair / Employee continue longer than the original placement agreement, the Agency is to be notified immediately and any additional fees will be due and payable to the Agency by the Host Family / Employer immediately, as per the current Agency Fee Schedule.

If an AuPair / Employee is introduced by the Host Family / Employer to a 3rd Party, which results in the employment of the AuPair / Employee, the full fee shall be payable to the Agency by the original Host Family / Employer immediately.


A refund will only be made provided that :

1)The Agency has been paid as per the terms noted above.

2) The Host Family / Employer gives written notice within 7 days and gives a minimum 7 days notice, after 3 months employment, as per Employment Standards legislation.

3) The AuPair / Employee has not left due to unreasonable conditions or conditions greatly different from those stated in the job description given to the Agency.

4) The Au Pair has received all wages and documentation ( T4 & ROE) owing as per legislation


*Please check here to indicate that all the information you submitted is correct and that you have read and agree with the Agency Policies and Fee Schedule.

Signature Date

Please Note: The Agency CANNOT GUARANTEE that a suitable Candidate on a Working Holiday Visa will be found . The number of applicants varies depending on when the Canadian Embassy in the applicants home country begins accepting applications for Working Holiday Visas, and when those who are successful in obtaining the visa want to come to Canada., The majority prefer to arrive in the summer or fall, with less arriving in the winter & spring. Also most are looking for a 6 to 10 month placement except occasionally those who are in university and are looking for a 3 month summer position.

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News/Upcoming Events


Childcare $11.54/hr.

Eldercare $13.91/hr.

Wages for caregivers on a work permit are now based on


for the region of the province in which they work.


Check : ESDC Website

At Camp CanAqua in Halliburton
June 16 – 18, 2017.

Au Pairs on Cultural Exchange placements are another option to meet your childcare needs!