Pre-registration - PRÉPARATION A L'HABILITATION ÉLECTRIQUE DES CHARGES D'INTERVENTION BR-BS

Private / self-employed Company

Sélectionnez ce mode si vous vous autofinancez.

Name of the private client *

First name of the private client *

Email of the private client *

Phone *

Address of the private client *

City *

Postcode *

Country

Date of birth of the private client *

Honorific of the private client *

Reconnaissance travailleur handicapé *

Nationality of the private client *

Profession of the private client

Select this mode if your company is financing your training or if you want to schedule training for your employees. The contact details to be filled in are those of the training contact.

Company name *

Company email *

Phone *

Company registration number

Company address

Company address (city)

Company address (postcode)

Company address (country)

The data collected in this form are processed by Fédération ENVIE to manage your pre-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