😊 Bienvenue sur la page d'inscription de la formation Massage AMMA ! Vous pouvez vous inscrire grâce à ce formulaire. Un devis vous sera envoyé, et vous pouvez laisser un message complémentaire dans la partie 'Notes libres'. Les inscriptions se font dans la limite des places disponibles, jusqu'à 10 jours avant le démarrage de la formation. Les informations recueillies sur ce formulaire sont enregistrées dans un fichier informatisé pour l'usage exclusif de l'EPSC (voir notre politique RGPD).

MrMrsMs-

Date of birth* Day01020304050607080910111213141516171819202122232425262728293031 / MonthJanuaryFebruaryMarsAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember / Year1930193119321933193419351936193719381939194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020202120222023

Postal code of place of birth

Language on the extranet: EnglishFrenchSpanishGerman

Address*

Postcode*

City*

Choose a countryAfghanistan 🇦🇫Åland Islands 🇦🇽Albania 🇦🇱Algeria 🇩🇿American Samoa 🇦🇸Andorra 🇦🇩Angola 🇦🇴Anguilla 🇦🇮Antigua & Barbuda 🇦🇬Argentina 🇦🇷Armenia 🇦🇲Aruba 🇦🇼Australia 🇦🇺Austria 🇦🇹Azerbaijan 🇦🇿Bahamas 🇧🇸Bahrain 🇧🇭Bangladesh 🇧🇩Barbados 🇧🇧Belarus 🇧🇾Belgium 🇧🇪Belize 🇧🇿Benin 🇧🇯Bermuda 🇧🇲Bhutan 🇧🇹Bolivia 🇧🇴Bosnia & Herzegovina 🇧🇦Botswana 🇧🇼Bouvet Island 🇧🇻Brazil 🇧🇷British Indian Ocean Territory 🇮🇴British Virgin Islands 🇻🇬Brunei 🇧🇳Bulgaria 🇧🇬Burkina Faso 🇧🇫Burundi 🇧🇮Cambodia 🇰🇭Cameroon 🇨🇲Canada 🇨🇦Canary Islands 🇮🇨Cape Verde 🇨🇻Caribbean Netherlands 🇧🇶Cayman Islands 🇰🇾Central African Republic 🇨🇫Ceuta & Melilla 🇪🇦Chad 🇹🇩Chile 🇨🇱China 🇨🇳Christmas Island 🇨🇽Cocos (Keeling) Islands 🇨🇨Colombia 🇨🇴Comoros 🇰🇲Congo - Brazzaville 🇨🇬Congo - Kinshasa 🇨🇩Cook Islands 🇨🇰Costa Rica 🇨🇷Côte d’Ivoire 🇨🇮Croatia 🇭🇷Cuba 🇨🇺Curaçao 🇨🇼Cyprus 🇨🇾Czechia 🇨🇿Denmark 🇩🇰Djibouti 🇩🇯Dominica 🇩🇲Dominican Republic 🇩🇴Ecuador 🇪🇨Egypt 🇪🇬El Salvador 🇸🇻Equatorial Guinea 🇬🇶Eritrea 🇪🇷Estonia 🇪🇪Eswatini 🇸🇿Ethiopia 🇪🇹Falkland Islands 🇫🇰Faroe Islands 🇫🇴Fiji 🇫🇯Finland 🇫🇮France 🇫🇷French Guiana 🇬🇫French Polynesia 🇵🇫French Southern Territories 🇹🇫Gabon 🇬🇦Gambia 🇬🇲Georgia 🇬🇪Germany 🇩🇪Ghana 🇬🇭Gibraltar 🇬🇮Greece 🇬🇷Greenland 🇬🇱Grenada 🇬🇩Guadeloupe 🇬🇵Guam 🇬🇺Guatemala 🇬🇹Guernsey 🇬🇬Guinea 🇬🇳Guinea-Bissau 🇬🇼Guyana 🇬🇾Haiti 🇭🇹Heard & McDonald Islands 🇭🇲Honduras 🇭🇳Hong Kong SAR China 🇭🇰Hungary 🇭🇺Iceland 🇮🇸India 🇮🇳Indonesia 🇮🇩Iran 🇮🇷Iraq 🇮🇶Ireland 🇮🇪Isle of Man 🇮🇲Israel 🇮🇱Italy 🇮🇹Jamaica 🇯🇲Japan 🇯🇵Jersey 🇯🇪Jordan 🇯🇴Kazakhstan 🇰🇿Kenya 🇰🇪Kiribati 🇰🇮Kosovo 🇽🇰Kuwait 🇰🇼Kyrgyzstan 🇰🇬Laos 🇱🇦Latvia 🇱🇻Lebanon 🇱🇧Lesotho 🇱🇸Liberia 🇱🇷Libya 🇱🇾Liechtenstein 🇱🇮Lithuania 🇱🇹Luxembourg 🇱🇺Macao SAR China 🇲🇴Madagascar 🇲🇬Malawi 🇲🇼Malaysia 🇲🇾Maldives 🇲🇻Mali 🇲🇱Malta 🇲🇹Marshall Islands 🇲🇭Martinique 🇲🇶Mauritania 🇲🇷Mauritius 🇲🇺Mayotte 🇾🇹Mexico 🇲🇽Micronesia 🇫🇲Moldova 🇲🇩Monaco 🇲🇨Mongolia 🇲🇳Montenegro 🇲🇪Montserrat 🇲🇸Morocco 🇲🇦Mozambique 🇲🇿Myanmar (Burma) 🇲🇲Namibia 🇳🇦Nauru 🇳🇷Nepal 🇳🇵Netherlands 🇳🇱New Caledonia 🇳🇨New Zealand 🇳🇿Nicaragua 🇳🇮Niger 🇳🇪Nigeria 🇳🇬Niue 🇳🇺Norfolk Island 🇳🇫North Korea 🇰🇵North Macedonia 🇲🇰Northern Mariana Islands 🇲🇵Norway 🇳🇴Oman 🇴🇲Pakistan 🇵🇰Palau 🇵🇼Palestinian Territories 🇵🇸Panama 🇵🇦Papua New Guinea 🇵🇬Paraguay 🇵🇾Peru 🇵🇪Philippines 🇵🇭Pitcairn Islands 🇵🇳Poland 🇵🇱Portugal 🇵🇹Puerto Rico 🇵🇷Qatar 🇶🇦Réunion 🇷🇪Romania 🇷🇴Russia 🇷🇺Rwanda 🇷🇼Samoa 🇼🇸San Marino 🇸🇲São Tomé & Príncipe 🇸🇹Saudi Arabia 🇸🇦Senegal 🇸🇳Serbia 🇷🇸Seychelles 🇸🇨Sierra Leone 🇸🇱Singapore 🇸🇬Sint Maarten 🇸🇽Slovakia 🇸🇰Slovenia 🇸🇮Solomon Islands 🇸🇧Somalia 🇸🇴South Africa 🇿🇦South Georgia & South Sandwich Islands 🇬🇸South Korea 🇰🇷South Sudan 🇸🇸Spain 🇪🇸Sri Lanka 🇱🇰St. Barthélemy 🇧🇱St. Helena 🇸🇭St. Kitts & Nevis 🇰🇳St. Lucia 🇱🇨St. Martin 🇲🇫St. Pierre & Miquelon 🇵🇲St. Vincent & Grenadines 🇻🇨Sudan 🇸🇩Suriname 🇸🇷Svalbard & Jan Mayen 🇸🇯Sweden 🇸🇪Switzerland 🇨🇭Syria 🇸🇾Taiwan 🇹🇼Tajikistan 🇹🇯Tanzania 🇹🇿Thailand 🇹🇭Timor-Leste 🇹🇱Togo 🇹🇬Tokelau 🇹🇰Tonga 🇹🇴Trinidad & Tobago 🇹🇹Tunisia 🇹🇳Turkey 🇹🇷Turkmenistan 🇹🇲Turks & Caicos Islands 🇹🇨Tuvalu 🇹🇻Uganda 🇺🇬Ukraine 🇺🇦United Arab Emirates 🇦🇪United Kingdom 🇬🇧United States 🇺🇸Uruguay 🇺🇾U.S. Outlying Islands 🇺🇲U.S. Virgin Islands 🇻🇮Uzbekistan 🇺🇿Vanuatu 🇻🇺Vatican City 🇻🇦Venezuela 🇻🇪Vietnam 🇻🇳Wallis & Futuna 🇼🇫Western Sahara 🇪🇭Yemen 🇾🇪Zambia 🇿🇲Zimbabwe 🇿🇼

Phone*

Status

EmployeeSelf-employedParticularChoose a value

Company

Profession*

Company name

Company registration number

Trainee's photo

Upload an image

Free notes

Pre-register

The data collected in this form are processed by Ecole des Pratiques de Santé Complémentaires - EPSC 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.