Learner registration

Information collective - 03/07 BPREA 2026 - from July 3, 2025 to November 5, 2025

Bonjour, merci de l'intérêt que vous portez à la formation "BP REA - Fermes agroécologiques urbaines et périurbaines" de l'Ecole Du Breuil. Afin de vous préinscrire, merci de remplir ce formulaire. Nous vous convoquerons sous peu en information collective suivie d'un entretien individuel.

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

Postcode of place of birth

Address*

Postcode*

City*

Country

Phone

Secondary phone

Language in the Learners' Portal

Status

Company

Profession

Company name

VAT number

Company registration number

Other

Free notes

Information for funding agencies

Social security number

Socio-professional category

Nature of the employment contract

Gross hourly wage

Disabled worker recognition

Fields marked with * are mandatory.

The data collected in this form is processed by Ecole Du Breuil 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