Pre-registration of a trainee

Posturologie Clinique (E-learning) - from April 21, 2021 to December 31, 2021

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'.

Date of birth* / /

Postcode of place of birth

Language on the extranet:

Address*

Postcode*

City*

Phone*

CPD fields

ADELI NO.

RPPS NO.

Main exercise (> 50%)*

Free notes

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Fields marked with * are mandatory.