Pre-registration of a learner

Grade A - 14/16 Janvier 2025- Formation Technicien du sommeil - Classe virtuelle - from January 14, 2025 to January 16, 2025

Vous pouvez préinscrire un stagiaire à la formation grâce à ce formulaire.
Merci de rentrer un maximum d'informations pour simplifier le travail d'enregistrement. Vous pouvez laisser un message complémentaire dans la partie 'Notes libres'.
Ne prenez pas en compte le champ "orientation nationales", cela ne vous concerne pas.

General information

Honorific

First name*

Last name* Email* Date of birth*

Nationality*

Postcode of place of birth

Address*

Postcode*

City*

Country*

Phone*

Language in the Learners' Portal

Status

Company

Profession*

DPC fields

RPPS NO.

Main exercise (> 50%)*

Other

Free notes

Information for funding agencies

Disabled worker recognition

Fields marked with * are mandatory.

The data collected in this form is processed by PSASS in order to manage your registration on the site. To find out more about the management of your personal data and to exercise your rights, we invite you to read our privacy policy