Formulaire d'inscription

Registration Form

Cohabitation request: you are looking for a house/apartment to share.
Date*

MonthDayYear
Date
Name*

First nameFamily name
Address*

Civic number and street

Complément d'adresse

Municipality/villageProvince/Region/State

Postal code/Zip code
Phone*
Please enter a valide phone number.
Email*
example@example.com
Your age bracket:*

18 to 3536 to 4546 to 5556 to 6566 to 7576 to 8586 or more

How did you hear about Avignon Home Sharing?*

FacebookWeb siteAcquaintances/relativesMediaLocal organizationOther**
**Please specify:
Birthplace:*
Occupation/profession/trade:*
Gender:*

MFNon-binary
Have you ever experienced apartment-sharing or house-sharing?*

Profile of the ideal host
The ideal host:*

WomanManNon-binary personNo preference
Personality, lifestyle, etc. *
What's really important concerning the host (sleep schedule, noise, activities, use of shared spaces, visitors, music, etc.).
Criminal record check
Do you authorize Avignon Home Sharing (Groupe ressource en logements collectifs GÎM) to have a specialized company conduct a criminal background check on you for the purpose of cohabitation?*

YesNo*
*Answering 'No' may reduce your chances of finding someone to live with.

References

People who know you well and, ideally, have already lived with you.
Name*

First nameFamily name
Phone number*
Please type a valid phone number.
E-mail
example@example.com
Relationship with you:*
Parent, friend, colleague, former or current roommate, etc.
Name*

First nameFamily name
Phone number*
Please type a valid phone number.
E-mail
example@example.com
Relationship with you:*
Parent, friend, colleague, former or current roommate, etc.

Registration Form