Au Pair International Area Director Reimbursement Form Type of Match: Arrival

Au pair Host family reimbursement

Your Name: New** New** $250
Date submitted: Rematch* New** $175
E-mail: New** Rematch* $125
Rematch* Rematch* $125
Send in e-mail attachment to: ginafudd@aupairint.com Extending 6 m w/ same host family $125
Extending 9 m w/ same host family $125
Extending 12 m w/ same host family $250
Instructions: write each host family/au pair per line. Add and delete lines as needed. *Rematch = au pair or host family switching replacing in the middle of their program year.
**New = au pair's first placement and host family starting a new program year (including renewal)

Arrival Reimbursement:
In-Home Meeting Date of Arrival
Host Family Name Au Pair Name Date of Arrival to Date of Welcome Call Type of Match* AP/HF Reimbursement Edits Notes
Date Meeting"
Host Family or
Date of Extension >New AP/New HF
Contact AP&HF within 48 In-person meeting w/ AP& >New AP/Remathc HF
NA for rematch,
Start hours of arrival. HF within 2 weeks of >Rematch AP/New HF
extension or done by NA for arrival. >Rematch AP/Rematch HF
(Last, First) other AD (Last, First) extensions NA for extensions >Extending (6, 9 or 12 m) Office use only Office use only

Hansson, Shelley and Jake 08/08/06 Caberro, Carol 10/11/06 10/12/06 10/18/06 New AP/New HF $250

Owen, Stephanie and Tim NA (rematch) Hansson, Maria 10/15/06 10/16/06 10/18/06 New AP/Rematch HF $125

Milano, Hanna NA (other AD) Laprich, Olga 10/01/06 10/02/06 10/05/06 Rematch AP/Rematch HF $125

Milan, Larui and Chris NA (extension) Svensson, Mille 10/05/06 NA (extension) NA (extension) Extending 6 months $125

$0

Sub total $625

Departure Reimbursement: Please attach your updated contact log for the au pairs leaving your cluster.
Complete Log
Host Family Name Arrival Au Pair Name Departure Date Months Served Au Pair Program Status Reimbursement Edits Notes
Enclosed

Re-match or Early >Extension

Return: last official date X (month #Y - #Z) >Completed 1st year
Date or month of Number of Months
with Host Family. >Completed 6, 9, 12 m ext. $250 per 12 months
(Last, First) Arrival in the US or (Last, First) Completed: date or MM.YY To MM.YY and Month Number Office use only Office use only
or $20.83/month
of Extension month Arrival Month = 1 >Rematch
Other: NA st. >Early Return

Jones, Milli and Jeff 10/15/05 Romero, Mona Oct 06 Oct 05 - Oct 06 12 (month 1-12) Completed $250

Andersson, Michelle and Rob Arr: Aug 06 Pachini, Christine 08/25/06 Aug 06 - Oct 06 4 (month 1 - 4) Early return $83

Odegaard, Janella Ext: May 06 Raaen, Monica Oct 06 May 06 - Oct 06 6 (ext. months 1-6) Completed 6 m Ext $125

mm/dd/yy mm/dd/yy $0

mm/dd/yy mm/dd/yy $0

Sub total $458

Recruitment Bonus and Other:

Is the Family in
Host Family Recruited by You** State Has Au Pair Arrived?*** Describe How/Where Host Family Was Recruited Bonus Edits Notes
Your Cluster?

(Last, First) Yes, No Yes, No e.g. Craig's list ad, magazine ad, friend, web/interest form, etc. Office use only Office use only

Hansson, Shelley and Jake CO Yes Yes A reply to one of my craigslist ads $100

$0

$0

** AD receive a $100 recruiting bonuses per host family directly recruited by you, inlcuding leads from interest forms/company website. Sub total $100
Referral bonuses by current host families are awarded to the family in the form of a credit towards future program fees and not to the AD.
** *Recruitment bonuses are paid after the au pair has arrived at the host family's home.
TOTAL $1,183