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Please register your care home

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.

Please register your care home to receive anonymous letters for your lodgers, to bring them smile back and make them enjoy their retirement.

Vous êtes :*
- Sénior à domicile (pour les questions 2-7-8 qui ne vous concernent pas, tapez "x" dans la case)
- EHPAD
- Résidence senior
- Autre résidence pour personnes âgées
- Aidant
- CCAS
- SAAD
- SSIAD
- ADMR
- UNA
- Saint-Vincent-de-Paul
- Croix-Rouge
- Petits Frères des Pauvres
- Guides / Scouts
- Protection civile
- Ensemble2générations
- Paroisses
- Centre Départemental de Repos et de Soins (CDRS)
- Autres
1 - Nom de la structure ou du sénior à domicile*
2 - Nom de la personne responsable*
3 - E-mail de la structure qui imprimera les lettres ou du sénior à domicile*
4 - E-mail de l'animatrice (pour les EHPAD et Résidence senior)
5 - Téléphone*
6 - Adresse de la structure qui imprimera les lettres OU adresse postale sénior à domicile*
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.
7 - Nombre de femmes dans l'établissement*
Please enter a number greater than or equal to 0.
8 - Nombre d'hommes dans l'établissement*
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
Hidden
Number of men in the establishment*
- 0 to 50
- 50 to 100
- more than 100
9 - Le logo de votre établissement
Max. file size: 8 MB.
10 - Acceptez-vous que nous mentionnions votre établissement parmi les destinataires des lettres ?*
Hidden
Would you like a refund for your printing costs?
*
- I confirm that someone is available to distribute letters in my establishment
Protected by reCAPTCHA
11 - Mot de passe*
12 - Confirmation mot de passe*

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Email*

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