1. I will fulfil all the necessary conditions to be an au pair (see general conditions) and make sure that the times and prices
will fit in with the timetable and budget.

2. I will send my application form by internet.

3. The Institut Parisien will send confirmation by email.

4. To validate my application, I will send a cheque to cover the deposit of 100 euros. This will be deducted from the total amount due. The student’s name must be written on the back of the cheque.

5. Upon receipt of my payment, I will receive two examples of two certificates of pre-enrolment for the academic year 2008/2009 (certificate of 10 hours per week = courses of 4 hours per week at least + homework).

YOUR EMAIL Email AU PAIR’S DETAILS Miss   Mr   Last name First name Nationality Date of birth   (dd-mm-yyyy) Date of arrival in France   (dd-mm-yyyy) Au pair agency in France Have you already taken lessons at the Institut Parisien? yes  no AU PAIR’S HOST FAMILY Name of the family Street   Post code    City Phone number  Fax Had you already heard about the Institut Parisien before visiting our website? If yes, how did you hear about us? If no, how did you find our website? General remarks I certify that I have read the conditions definied by the Institut Parisien and I accept all of them. Please enter the code shown: