Pre-registration of a learner

ANNULEE_Autogestion des émotions et du stress - from October 15, 2020 to October 16, 2020

Vous pouvez préinscrire un stagiaire 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

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Last name* Email* Date of birth*

Nationality

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Postcode of place of birth

Address*

Postcode*

City*

Phone*

Language in the Learners' Portal

Status

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DPC fields

ADELI NO.*

RPPS NO.*

Main exercise (> 50%)*

Other

Free notes*

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