Formulaire d'inscription

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?*

Health status/limitations*
What motivates you to welcome someone into your home?*
What would you like to take away from this experience?*
Tell us about yourself, to help us match you with someone with whom you'll live in harmony.*
Your tastes, your hobbies/activities, your life rhythm (early bird, night owl...), etc.
Your everyday life/your restrictions:*

SmokerAllergies**Religious practices**Animals**
**Please specify:*
House/apartment features

What you are offering
Address*

Civic number and street

Complément d'adresse

Municipality/village

Code Postal
Area and services (your environment, proximity to services, etc.).*
Transportation, grocery stores, pharmacies, beaches, walking paths, other proximity services...
Type of home and amenities (rooms, size, lot, balcony) Describe your living environment and shared spaces.*
Space offered (details on the room(s) you are offering: furniture, storage, dimensions, etc.) and services included (cable, snow removal, Internet, heating, etc.).*
Proposed conditions (the monthly amount requested or the services requested in exchange, the proposed duration, from what date cohabitation is available, the conditions of cohabitation, etc.).*

Caractéristiques de la personne recherchée...
Your ideal housemate:*

WomanManNon-binary personNo preference
Personality, lifestyle, etc. *
What's really important for you (schedule, noise, activitiess, shared spaces usage, visitors, music, etc.).
Other important information about you or what you have to offer:
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.Format: (000) 000-0000.
E-mail
exemple@exemple.com
Relationship with you:*
Parent, friend, colleague, former or current roommate, etc.
Name*

First nameFamily name
Phone number*
Please type a valid phone number.Format: (000) 000-0000.
E-mail
example@example.com
Relationship with you:*
Parent, friend, colleague, former or current roommate, etc.

Registration form