Au-Pair-Certificate

We hereby certify that Miss

Name : Sandra Mustermann
Born on , 05.01.1983

between the dates of 03.08.02 and 03.08.03 successfully took part in the Au-Pair Program in Germany .

Miss, Sandra Mustermann
was employed by
Family: Michael and Jennifer Mustermann
Msterstr. 14
D-01234 Musterhausen

Presented by the Placement Organisation

Agency

Beerfelden, den 30.09.03

Stempel/Unterschrift