Registration Form – Incoming Twin
By completing this form, you confirm your interest in being matched with a person living in the region as part of the Portes ouvertes sur le Lac’s (POL) intercultural twinning program. Thank you for your interest! Do not hesitate to contact us for more information: jumelage@polac.org 

You can also visit our Facebook page : https://www.facebook.com/portesouvertessurlelac2006

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1. Last name *
2. Name *
3. Gender
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4. What age group do you belong to? *
5. What is your marital status? *
6. Do you have children? *
7. If yes, what are their respective ages
8. If you have a spouse and/or children, are they with you in Quebec and will they be involved in the match?
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9. Full Address (Street Number, City, Postal Code) *
10. What modes of transportation do you generally use? (Check all that apply) *
Required
11. Phone number *
12. Email *
13. What is the easiest way to reach you? *
Required
14. Country of Origin
15. How long have you been in Canada?
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16. What is your status in Canada?
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17. What languages do you speak? *
18. How would you rate your level of French proficiency?* This is not a selection criterion. It will simply be used to make better matches and adapt our coaching services
19. What is your last level of education completed? *
20. What is your field of study? *
21. What is your occupation? *
22. How did you hear about the intercultural twinning project? * *
Required
23. What are your motivations for participating in a match? *
24. The twinning’s Program involves one meeting per two weeks, for a period of one year. We estimate this commitment to be 4-6 hours per month. Are you available to participate? *
25. If you answered “More or less” to the previous question, specify here what your constraints are.
26. Are you more available (check all that apply): *
Required
27. When would you be available to participate in the intercultural twinning project? *
28. What activities, hobbies or interests would you like to share with your twin? *
29. Are there people you know who would also like to participate with you in the program (family, friends, co-workers, etc.)?
30. If you have any preferences regarding the person you will be paired with, please specify them here. Check all that apply** However, we cannot guarantee that these preferences will be respected *
Required
31. When can we contact you? *
32. Are there any other elements that you would like to share or that we should consider regarding the match?
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