Pre-registration of a trainee

ANNULE_Assistant de soins en gérontologie - from September 7, 2020 to December 4, 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'.

Nationality

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Date of birth* / /

Postcode of place of birth

Language on the extranet:

Address*

Postcode*

City*

Phone*

Status

Profession*

CPD fields

ADELI NO.*

RPPS NO.*

Main exercise (> 50%)*

Free notes*

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