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BOORAEM FLOWERS AU PAIR SELECTION TEST

ANSWER SHEET
(Please print clearly)

Name:

___________________________________________________________________________
Last

First

Middle

Address: ___________________________________________________________________________
Street / Postal Box

___________________________________________________________________________
City

Date of Birth:

State/Province

Zip/Postal code

_______/_______/_________
Day

Month

Country

Pax Number: ___________________________

Year

(Office use only)

Country of Birth:________________________ County of Residence:


Have you lived in another country?

Yes

________________________

No

If yes, which country? ___________________________________ For how long? __________________


Native Language:________________________________ Years of English: _______________________
Religion: __________________________________________

Active

Inactive

Number of years of Education: ___________________________________________________________


Name of Test Administrator:________________________________ Date:________________________

Office use only:

BOORAEM FLOWERS AU PAIR SELECTION TEST

NAME:_____________________________

Instructions: Circle the number that best describes how you act. There are no right or wrong answers, only answers that describe you.

1) --1---2----3----4----5-- 16) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

2) --1---2----3----4----5-- 17) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

3) --1---2----3----4----5-- 18) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

4) --1---2----3----4----5-- 19) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

5) --1---2----3----4----5-- 20) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

6) --1---2----3----4----5-- 21) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

7) --1---2----3----4----5-- 22) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

8) --1---2----3----4----5-- 23) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

9) --1---2----3----4----5-- 24) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

10) --1---2----3----4----5-- 25) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

11) --1---2----3----4----5-- 26) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

12) --1---2----3----4----5-- 27) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

13) --1---2----3----4----5-- 28) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

14) --1---2----3----4----5-- 29) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

15) --1---2----3----4----5-- 30) --1---2----3----4---5-Never seldom sometimes often very often

Never seldom sometimes often very often

31) --1---2----3----4---5-Never seldom sometimes often very often

32) --1---2----3----4---5-Never seldom sometimes often very often

33) --1---2----3----4---5-Never seldom sometimes often very often

34) --1---2----3----4---5-Never seldom sometimes often very often

35) --1---2----3----4---5-Never seldom sometimes often very often

36) --1---2----3----4---5-Never seldom sometimes often very often

37) --1---2----3----4---5-Never seldom sometimes often very often

38) --1---2----3----4---5-Never seldom sometimes often very often

39) --1---2----3----4---5-Never seldom sometimes often very often

40) --1---2----3----4---5-Never seldom sometimes often very often

41) --1---2----3----4---5-Never seldom sometimes often very often

42) --1---2----3----4---5-Never seldom sometimes often very often

43) --1---2----3----4---5-Never seldom sometimes often very often

44) --1---2----3----4---5-Never seldom sometimes often very often

45) --1---2----3----4---5-Never seldom sometimes often very often

46) --1---2----3----4---5-Never seldom sometimes often very often

47) --1---2----3----4---5-Never seldom sometimes often very often

48) --1---2----3----4---5-Never seldom sometimes often very often

49) --1---2----3----4---5-Never seldom sometimes often very often

50) --1---2----3----4---5-Never seldom sometimes often very often

51) --1---2----3----4---5-Never seldom sometimes often very often

52) --1---2----3----4---5-Never seldom sometimes often very often

53) --1---2----3----4---5-Never seldom sometimes often very often

54) --1---2----3----4---5-Never seldom sometimes often very often

55) --1---2----3----4---5-Never seldom sometimes often very often

56) --1---2----3----4---5-Never seldom sometimes often very often

57) --1---2----3----4---5-Never seldom sometimes often very often

58) --1---2----3----4---5-Never seldom sometimes often very often

59) --1---2----3----4---5-Never seldom sometimes often very often

60) --1---2----3----4---5-Never seldom sometimes often very often

61) --1---2----3----4---5-Never seldom sometimes often very often

62) --1---2----3----4---5-Never seldom sometimes often very often

63) --1---2----3----4---5-Never seldom sometimes often very often

64) --1---2----3----4---5-Never seldom sometimes often very often

65) --1---2----3----4---5-Never seldom sometimes often very often

66) --1---2----3----4---5-Never seldom sometimes often very often

67) --1---2----3----4---5-Never seldom sometimes often very often

68) --1---2----3----4---5-Never seldom sometimes often very often

69) --1---2----3----4---5-Never seldom sometimes often very often

70) --1---2----3----4---5-Never seldom sometimes often very often

71) --1---2----3----4---5-Never seldom sometimes often very often

72) --1---2----3----4---5-Never seldom sometimes often very often

73) --1---2----3----4---5-Never seldom sometimes often very often

74) --1---2----3----4---5-Never seldom sometimes often very often

75) --1---2----3----4---5-Never seldom sometimes often very often

BOORAEM FLOWERS AU PAIR SELECTION TEST SCORE SHEET


NAME OF APPLICANT: _____________________________________________________________

Instructions: First transfer the number selected by the candidate for each item to the corresponding box in the
appropriate Scale. Total each Scale. Using the Total for each Scale, refer to the listing below to interpret the
score. Candidates may not be accepted when a candidate demonstrates two possible problem areas, i.e. two or
more scales meet the criteria for rejecting the candidate.

Scale A:
Item #
1
9
17
25
33
Total

Score

A total score of 5 does not mean that


the candidate is rejected, but it does
mean that the interviewer should be
asked to carefully assess if they
believe the candidate was trying to
present themselves too favourable.
A total above 5 indicates the candidate
is being more truthful on the test.

Scale B:
Item #
2
10
18
26
34
Total

Score

A total of 11 indicates a possible


problem. A total score of 12 or more
meets the criteria for rejecting the
candidate.

Scale C:
Item #
4
8
12
20
28
Total

Score

A total of 17 indicates a possible


problem. A total score of 18 or more
meets the criteria for rejecting the
candidate.

Scale D:
Item #
5
13
21
29
36
42
48
Total

Score

A total of 21 or 22 indicates a
Possible problem. A total score of
23 or more meets the criteria for
rejecting the candidate.

Scale E:
Item #
6
14
22
30
37
43
49
53
56
Total

Score

Score

A total of 18 or 19 indicates a possible


problem. A total score of 20 or above
meets the criteria for rejecting the
candidate.

Scale H:
Item #
40
46
47
Total

Score

A total of 9 indicates a possible


problem. A total score of 10 or above
meets the criteria for rejecting the
candidate.

A total of 25 indicates a possible


problem. A total score of 26 or above
meets the criteria for rejecting the
candidate.

Scale F:
Item #
7
15
23
31
38
44
50
52
54
55
58
Total

Scale G:
Item #
8
16
24
32
39
45
51
Total

Score

A total of 26 or 27 indicates a possible


problem. A total score of 28 or more meets
the criteria for rejecting the candidate.

Scale I:
Item #
57
59
60
61
62
63
64
65
Total

Score

A total of 18 indicates a possible


problem. A total score of 19 or above
meets the criteria for rejecting the
candidate.

AUPAIR SELECTION INTERVIEW

STRUCTURED INTERVIEW
(Please print clearly)
It is necessary that each au pair applicant be interviewed. The interview must be conducted exclusively in
English. Applicant responses and interviewer impressions should be recorded by the interviewer on this
form.

_______________________________________________

_________________________________

Applicant Name

Nationality

____________________________
Applicant Birth date

___________
Age

_________________________________
Interview Date

_______________________________________________

_________________________________

Interviewers Name

Interviewers Contact Telephone Number

1.

Where was the applicant born and raised? ______________________________________________


_________________________________________________________________________________
_________________________________________________________________________________

2.

Has the applicant spent any time away from home (other than holidays), family and
friends?
Yes
No
If yes, where? ____________________________________________________________________
How much time? __________________________________________________________________
And, for how long? ________________________________________________________________

3.

Has the applicant spent time in an English-speaking country?

Yes

No

If so, which country(ies)? ___________________________________________________________


_________________________________________________________________________________
How much time? __________________________________________________________________
And, what was she/he doing there? ____________________________________________________
_________________________________________________________________________________
4.

What is/was the occupation/profession of the applicants mother and/or father?


Mother: _________________________________________________________________________
Father: __________________________________________________________________________

AUPAIR SELECTION INTERVIEW

5.

Ask the applicant to describe her/his family and the relationships between its members.
(Are both parents alive and currently living together? Are siblings at home, or have they moved
away? Is the family close and loving? What is the frequency of family member contact?)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

6.

Has the applicant discussed with her/his family her/his decision to spend a year abroad?
Yes
No Does the entire family support the applicants decision to spend a year in the
U.S.A. as an au pair?

Yes

No

If no, explain who doesnt and why not.

_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
7.

How does the applicant get along with her/his:


Mother:

Excellent

Very Good

Good

Fair

Poor

Father:

Excellent

Very Good

Good

Fair

Poor

Siblings:

Excellent

Very Good

Good

Fair

Poor

Excellent

Very Good

Good

Fair

Poor

Other:

8.

___________

Is the applicant actively religious (attending church/temple regularly)?

Yes

No

If yes, how would the applicant deal with being placed in a family where a church/temple of her/his
religious denominations is not easily accessible?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
Give an example of the applicants tolerance of religious beliefs or practices other than her/his own.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
9.

What does the applicant expect or envision her/his American family might be like? (two-parent
family, one parent, both work, one works, city apartment, suburban house, cars, friendly, busy, rich,
etc) _____________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

AUPAIR SELECTION INTERVIEW

10.

Does the applicant consider her/himself flexible and able to adjust to the lifestyle and culture of a
new family?
Yes
No
What qualities and characteristics does the candidate consider
important to the adjustment process?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

11.

How does the applicant feel about living with a family with very different political or philosophical
beliefs?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

12.

How does the applicant spend her/his free days now? (reading, jogging, swimming, studying, etc)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

13.

How does the applicant spend her/his free nights? (films, reading, discos, coffee shops, T.V., etc)
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

14.

Does the applicant have many or few friends?

Many

Few

Ask the applicant to describe

what she/he considers the most important qualities of a good friendship.


_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
15.

Does the applicant currently have a serious romantic relationship?

Yes

If yes, does the applicant feel she/he can live without this person for an entire year?
Has the applicant discussed with this person her/his decision to spend a year abroad?

No
Yes
Yes

No
No

If yes, how does her/his boy/girlfriend feel about spending 12 months without her/him, or if no
(havent discussed), why not?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

AUPAIR SELECTION INTERVIEW

16.

What does the applicant plan to do upon her/his return from her/his au pair year in the USA? (job,
school, training, family, travel, etc)?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

17. Does the applicant plan to marry and/or have children of her/his own?

Yes

No

If yes, what is her/his idea of the timing (of marriage, home, children) and her/his concept of what
her/his family lifestyle would be (close-knit, active, outdoors, city, travel, farm)?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
18.

Does the applicant understand that she/he will be the primary care provider for the host familys
children for up to 45 hours each week?
Yes
No
Have the applicant describe the
characteristics and skills she/he considers to be the most important in successfully undertaking this
responsibility.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
What problems or challenges does the applicant expect to encounter?
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

19.

Why does the applicant wish to become an au pair?


_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

20.

Does the applicant have any other information that she/he feels is important or useful for the program
to know in placing her/him with a host family and its children?
Yes
No
If yes, please explain.
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________

Dear Partners:
It is vital that all Au Pair applicants are aware of the challenges of living overseas and providing live-in
childcare. To ensure that they are aware of these challenges and that they are able to deal with these
challenges as they arise, we have listed some of the issues below. Please present the Au Pair with these
situations and ask him/her how she/he would deal with the situation:
1) Culture Shock
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
2) Homesickness___________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

3) Driving Issues(Discomfort driving, driving accident, speeding ticket)


_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
4) Language Issues ( Having trouble understanding family, inability to express yourself in English)
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
5) Childcare Issues ( Children do not listen to you, children cry when parents are gone. . )
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
6) Host Family Concerns (If you do not feel like part of the family, if you do not understand the
familys schedule )
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
7) Other challenges/issues
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________