Pre-registration of a learner

Dry Needling 2025 Strasbourg - from February 16, 2025 to April 26, 2025

Vous pouvez vous préinscrire à la formation grâce à ce formulaire puis envoyer votre convention par courrier avec le règlement par chèque.
Merci de rentrer un maximum d'informations pour simplifier le travail d'enregistrement et n’hésitez pas à laisser un message complémentaire dans la partie 'Notes libres'.

General information
Status
DPC fields
Other
Fields marked with * are mandatory.
The data collected in this form is processed by ÉVOLUTION KINÉ 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

Personnalisez le contenu de l'e‑mail

Envoyer l'e-mail avec un délai

Select a date below Delivery will be scheduled on {{formattedDate}}
Predefined time limit
Tomorrow Next Monday In 1 week In 1 month In 2 months In 3 months
Date sent
Time of sending
Please note that if you add learners or change existing learner emails after scheduling the sending, these changes will not be taken into account.

Select at least one line Select the legal representative or sponsor

Select people

Multiple recipients selected
All selected signatories must sign for the signature to be valid!