Pre-registration of a learner

CIP MODULE 1, 2 et 7 - from March 11, 2024 to March 14, 2024

Vous pouvez préinscrire un apprenant 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

Honorific

First name*

Last name* Email* Date of birth*

City of birth*

County of birth*

Phone*

Language in the Learners' Portal

Status

Company*

Profession*

Company name*

Other

Free notes

Information for funding agencies

Social security number*

Nature of the employment contract*

Disabled worker recognition

Fields marked with * are mandatory.

The data collected in this form is processed by INITIATIV' FORMATION 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