Pre-registration of a learner

Créer une mare naturelle - from May 31, 2024 to June 2, 2024

Vous pouvez vous préinscrire ou préinscrire un de vos stagiaires 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

Learner's photo

JPG, PNG or WebP, ≤ 500Ko

Honorific

First name*

Last name* Email* Nationality

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.

The data collected in this form is processed by SAS Permaculture Design 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