Pre-registration of a learner

FC - Digitaliser la communication de son association sportive - from July 11, 2024 to November 11, 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* Date of birth*

Birth name*

Nationality*

City of birth*

County of birth*

Address*

Postcode*

City*

Country

Phone*

Language in the Learners' Portal

Other

Free notes

Information for funding agencies

Social security number*

Disabled worker recognition

Fields marked with * are mandatory.

The data collected in this form is processed by PIKANGO 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