“I’m going” form

* indicates required field

You are a*

What is your exact name as per your passport?*

Gender*

Date of birth*

Your age this year is or will be*

Do you have a personal email address?*

Your email address is (If any)

Do you have a personal mobile number?*

Your mobile number is (If any)

School name (If any)

Your address*

Your pin code*

Your city*

Your house phone number

Your father name*

Your father mobile phone number*

Your father email address

Your mother name*

Your mother mobile phone number*

Your mother email address

How many brothers do you have?*

How many sisters do you have?*

Diet*

If you have diet restrictions on specific days, tell us more

Tell us more about your taste (Food)*

Are you on Facebook?*

Your height is*

Do you like sport?*

Do you know how to ride a bicycle?*

Do you know how to swim?*

Tell us more about your hobbies (Activities, sport, music, danse...)*

What is your blood group?*

You are allergic to something?*

If you have allergies, tell us more about it

If you have health difficulties or take medicines, tell us more about it

If you have traveled abroad, tell us which countries you have visited

Tell us what you would like to do during the Exchange Program*

Are you planning to get a French Sim card?*

Add a photo of you (Avoid sad ID photos!)

Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 10mb.

Your host family would love to see a photo of you and your family

I confirm that my name on the passport is*

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