Pre-registration of a learner

EL2- Novembre 2024 -Lecture de polygraphie ventilatoire : lecture approfondie - from November 1, 2024 to November 30, 2024

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.

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