Pre-registration of a learner

SÉDIMATÉRIAUX : prise en main de la méthode pour accompagner les démarches de valorisation des sédiments - the October 9, 2020

Vous pouvez préinscrire un stagiaire à la formation grâce à ce formulaire. Merci de rentrer un maximum d'informations pour simplifier le suivi de votre dossier d'enregistrement. Vous pouvez - bien entendu - laisser un message complémentaire dans la partie 'Notes libres'

General information

Learner's photo

JPG, PNG or WebP, ≤ 500Ko

Honorific

First name*

Last name* Email* Date of birth*

Birth name

Nationality

City of birth

County of birth

Postcode of place of birth

Address*

Postcode*

City*

Country*

Phone*

Secondary phone*

Language in the Learners' Portal

Status

Company*

Profession*

Company name

VAT number*

Company registration number*

Other

Free notes

Information for funding agencies

Social security number

Socio-professional category

Nature of the employment contract

Gross hourly wage

Disabled worker recognition

Fields marked with * are mandatory.

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