Digiforma

Pre-registration of a trainee

Prévenir de la perte de l’autonomie d’une personne âgée vivant à domicile ou en structure d’accueil (INTRA EDMOND GARCIN) - du December 14, 2022 au December 15, 2022

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'.

Nationality

Birth name

City of birth

Birth department

Date of birth* / /

Postal code of place of birth

Language on the extranet:

Address

Postcode

City

Phone*

Secondary phone

Status

Company

Profession*

Company name

VAT NO.

Company registration number

Trainee's photo

Free notes

Information for funders

Social security number

Socio-professional category

Nature of the employment contract

Gross hourly wage

Disabled worker recognition

The data collected in this form are processed by HEKADEMY, Organisme de Formation en Santé 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

Fields marked with * are mandatory.