Update your record ::

To help ensure our records are up to date please fill out this form with your most current contact information, and don’t forget to press “Submit” so that we can process the form.

If you prefer, you can contact our alumni tracker at alumni-anciens@cwy-jcm.org or by calling 514-931-1614 ext. 362.

Personal Information

First name:

Last name:

Last name at time of program (if different from above):

Date of birth (yyyy/mm/dd):

Gender: male female

Spouse’s first and last name if also a past participant:

First name

Last name

Contact Information

Street address:

City:

Province:

Country:

Postal code:

Evening phone:

Day phone:

E-mail address:

Program Information

Exchange country: Faso & Tobago

Canadian community:

Year:

Resident province or territory at time of application:

Were you a:

Canadian participant
Overseas participant
Canadian field staff
Overseas field staff

Optional information

What are you doing now? (type of work, employer)

Are you involved in volunteer work? yes no

Briefly describe your activities.

Would you like us to send you application information for a potential participant?

yes no

(You may also visit our application page)

Do you consent to having your name and contact information given to other past participants for the purpose of Alumni activities?

yes no




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