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Buddy request Form

Please, complete the following form at your earliest convenience. This information will help us in looking for your potential buddy.

Family name*
First name*
Date of birth*
Gender* male  female
Email*
Nationality*
Spoken languages
My FB / other social network profile(s)
I'm planning to arrive approximately (fill in the date)*
I'm planning to stay till approximately (fill in the date)*
I would like to request* male  female  doesn't matter
My fields of interest
Additional information

Add photo (that is optional but will be helpful if you need to be met at arrival). Please, no more than 400px on any side and no more than 1Mb!

Captcha New image
 
  

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