Pre-registration of a learner

Distribution électrique pour le spectacle (13092021) - from September 13, 2021 to September 17, 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'.

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*

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 E-LIGHT 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