Celiac Siblings Program Application
Welcome!
Apply Now!
 
What's your name?

 
How old are you?

 
Where are you from?

You do not need to put an exact state or city if you are not comfortable, as long as you state which country you are from.
 
When were you diagnosed with Celiac Disease?

If you don't know the exact date, that's okay! Just give a rough estimate of how long you've been gluten free
 
Tell me a bit about yourself!

Depending on the number of applicants, we will try to pair you with someone who shares your interests.
 
What's the best way to contact you?


 
Please leave your email, phone number, or social media account link below.

I will contact you using this method to confirm your submission and to introduce you to your pair.
 
Awesome! Now on to your pair preferences. We will try to make sure you are matched with someone who fits your criteria, but that might delay your pairing.

 
Does the age of your pair matter to you?

Remember, everyone applying will be a teenager or in their early twenties. You will not be paired with someone more than five years older/younger than you. If you would prefer a smaller age margin (2-3 years apart), please select yes.
     
 
Does the location of your pair matter to you?


 
Does the gender of your pair matter to you?


 
Any other preferences?

 
You're all done! You will be contacted by Valerie, the admin of The Celiac Saga, within a few days to confirm your submission. Thank you for signing up.

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