Register

Au Pair Information

First Name *

Last Name (Surname) *

Au Pair Email Address: *

Au Pair Phone Number: *

Gender *

Female
Male

My Au Pair Company is: *

Host Family Name: *

Au Pair Country: *

U.S. Mailing Address: *

Address Line 1

City

State

Zip Code

Courses you would like to enroll in:

Courses Offered *

In Person Weekend Courses
Online Courses

Online Course Options *

36-Hour Courses
12-Hour Courses

36-Hour Courses Offered *

AP 201 - Au Pair Personal Development - $ 250.00
AP 202 - Au Pair Introduction to Permaculture - $ 250.00
AP 203 - Development of Personal Skills - $ 250.00
AP 204 - Personal Advancement - $ 250.00
AP 205 - Americana - $ 250.00

12-Hour Courses Offered *

AP 200 A - $ 120.00
AP 200 B - $ 120.00
AP 200 C - $ 120.00
AP 200 D - $ 120.00

In Person Weekend Courses Offered *

Sept 29- 0ct 1, 2023 – AP 109 Silver Bay NY - $ 400.00
Oct 20-22, 2023 – AP 110 Silver Bay NY - $ 400.00
Nov 17-19, 2023 – AP 111 Silver Bay NY - $ 400.00
Dec 15-17, 2023 – AP 112 Albany NY - $ 400.00

Check this box, if you are registering less than 2 weeks before the course, the cost will be $400

Late Fee - $ 30.00

NOTE:

In-person weekend courses are $400 for each course. If you're registering for more than one course, you need to complete and submit a separate form for each weekend.

LOCATIONS: Silver Bay YMCA Conference Center in Silver Bay NY or The Century House Conference Center and Hotel, Latham NY (Albany)

RESPONSIBILITY: I understand that Silver Bay, The College of Saint Rose, Silver Bay Au Pair Courses LLC, the program director, faculty, participating agencies, and personnel are acting in good faith and shall not be liable for damages, loss, expense, injury, or inconvenience to person or property resulting from any cause whatsoever. I also understand it is my responsibility to get to and from the course. I also agree to attend all sessions and not to use alcohol or drugs. I understand there is homework and other important information noted on the website.

Signature *

Date *

Name of Roommate:

This can be provided later or we will assign 2 per room with 2 beds.

Dietary Restrictions *

Select Payment Method *

Card Number

Expiration Date

Security Code

Card Holder Name

Payment Information

Total

$ 0.00

Au Pair Information

Courses you would like to enroll in:

Payment Information

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