Pre-registration of a learner

VAE- Préinscription

Vous souhaitez valider un diplôme grâce à votre expérience professionnelle? Vous souhaitez obtenir des informations et assister à notre prochain webinaire. Merci de remplir ce formulaire en nous donnant le maximum d'informations. Utilisez l'espace "Note libre" pour préciser le diplôme que vous souhaitez obtenir.

General information

Honorific

First name*

Last name* Email* Birth name

Nationality

Postcode of place of birth

Address

Postcode

City

Country

Phone*

Secondary phone

Language in the Learners' Portal

Status

Company

Profession

Company name

Company registration number

Custom fields

Fonction du signataire

Contact 2 signataire

Contact 1 signataire

Signataire convention

Other

Free notes

Information for funding agencies

Nature of the employment contract

Disabled worker recognition

Fields marked with * are mandatory.

The data collected in this form is processed by AVI CONSEIL 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