Pre-registration of a learner

Autohypnose Peurs et Anxiété - from June 18, 2022 to June 19, 2022

Vous pouvez préinscrire un apprenant 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'.

General information

Honorific

First name*

Last name* Email* Date of birth

City of birth

Postcode of place of birth

Address

Postcode

City

Phone*

Language in the Learners' Portal

Status

Company

Profession

Other

Free notes

Information for funding agencies

Disabled worker recognition

Fields marked with * are mandatory.

The data collected in this form is processed by Christine Magat 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