Pre-registration of a learner

L'alimentation en pleine conscience (Classe virtuelle) - from September 30, 2025 to February 3, 2026

Vous pouvez vous préinscrire ou préinscrire un apprenant à la formation grâce à ce formulaire. Nous vous remercions de saisir 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

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*

DPC fields

ADELI NO.

Other

Free notes*

Information for funding agencies

Disabled worker recognition

Fields marked with * are mandatory.

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