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Last name (*)
First name (*)
Gender (*) Select from the list Male Female Non-binary Prefer not to respond
E-mail address (*)
Phone number (*)
Nationality / nationalities (*)
Name of home university (*)
Faculty at UT Capitole (excluding TSE and TSM) (*) Select from the list Law and Political Science Administration and Communication Information Science
Year of study (*) Select from the list 1st year bachelor (L1) 2nd year bachelor (L2) 3rd year bachelor (L3) 4th year bachelor 1st year master (M1) 2nd year master (M2)
When would you like to participate in the Captiole Buddy Program? (*) Select from the list Semester I Semester II Year
If yes, would you like to share additional information with us?
Would you like to inform us of a disability? Select from the list Yes No
What is your native language? (*)
Second native language (if applicable)
Do you speak any other languages? If yes, please specify:
Do you have a preference regarding the gender of your buddy? (*) Select from the list Female Male Non-binary I don't have a preference
Is there anything else you would like to share with us?
Please upload your commitment form completed and signed (PDF format only) (*)
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