Pre-registration of a learner

RECYCLAGE AFGSU 2 | INTER ETABLISSEMENTS EUROMEDICARE / LYON - the October 16, 2023

Vous pouvez préinscrire un apprenant 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

Honorific

First name*

Last name* Email* Date of birth*

Birth name*

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

Fields marked with * are mandatory.

The data collected in this form is processed by EUROMEDICARE FORMATION 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