FOLLOW UP FORM FOR THE AU PAIRS

Name of the Au Pair:

Dutch phone number: (if you did not provide yet)
Name of the host family:
Do you still enjoy your exchange year? Yes/no
If no, please clarify…………………………………………………………………………………………………………
Do you get possibility to attend the language course? Yes/no
If no, please clarify…………………………………………………………………………………………………………
Do you get enough time to explore the Netherlands? Yes/no
If no, please clarify…………………………………………………………………………………………………………
Do you still work according to signed schedule? Yes/no
If no, please clarify…………………………………………………………………………………………………………
Do you have any complains about your host family? Yes/no
If yes, please clarify………………………………………………………………………………………………………
Do you have any complains about your tasks? Yes/no
If yes, please clarify………………………………………………………………………………………………………
Are there any other changes in your personal situation? Yes/no
If yes, please clarify………………………………………………………………………………………………………
Do you have any relationship (in the Netherlands) at this moment? Yes/No
Are you still planning to leave the country after the exchange year? Yes/No
If no, please clarify…………………………………………………………………………………………………………
Are you participating in cultural exchange events organized by the agency? Yes/No
If no, please clarify…………………………………………………………………………………………………………
Any other comments…………………………………………………………………………………….................

The information I (your name)…………………………………… give is true and correct.

Date: 22-04-2023

Signature: