La Maison Entre Familles
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Registration Form
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Name
*
First
Last
Cell Number #
*
Email
*
3 1st digit of postal code (H3A, H8Y, etc.)
*
Family Situation
*
— Select Choice —
Single
Single with kids
Married
Family with kids
Elderly couple
Widow
Student
Divorce
Family net income
*
— Select Choice —
< 19,999$
20,000$ – 29,999$
30,000$ – 39,999$
40,000$ – 49,999$
50,000$ – 59,999$
60,000$ – 69,999$
> 70,000$
How many kids
*
— Select Choice —
No kids
1
2
3
4+
kids income Family
Food preference
None
Halal
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