Register your care home to receive letters:

This form allows retirement homes, nursing homes or other establishments caring for older people to be registered to receive letters. If you wish to write a letter, please fill the « Write a letter » form, in yellow in the menu, not this one.

Facility Name*
Name of the person who will distribute the letters*
Email*

Enter the email of the contact person who can take care of the distribution, or the email of the establishment.
Phone*
Address*
Street Address Address Line 2 City Postal code Country

We will use your address to verify that you are a care home or a residence for the elderly.
Number of women in the establishment*
Please enter a number greater than or equal to 0.
Number of men in the establishment*
Please enter a number greater than or equal to 0.
Hidden
Number of women in the establishment*
- 0 to 100
- 100 to 200
- more than 200
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Number of men in the establishment*
- 0 to 50
- 50 to 100
- more than 100
Do you accept that we mention your establishment among the recipients of the letters?*
Hidden
Would you like a refund for your printing costs?
*
- I confirm that someone is available to distribute letters in my establishment
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Password*

Your password must contain: 1 upper case letter, 1 lower case letter, 1 number and at least 8 characters.
Password confirmation*