DIAG.Lexd Registration from Toulouse

CONTACT

Company: *

Address: *

Postcode: *

City and country: *

Phone: *

Name and First Name of the training manager: *

Email of the training manager: *

TRAINING PARTICIPANTS

Name and First name of the PARTICIPANT n°1: *

Email of the participant n°1: *

Name and First name of the PARTICIPANT n°2:

Email of the participant n°2:

To include other participants, thank you for informing their name, first name and email:

REGISTRATION FEES

PRICE OF TRAINING

• € Tax free / Person - for holders of the maintenance contract
• € Tax free / Person - for not holding the maintenance contract

Are you the owner of the DIAG.Lexd® maintenance contract ?: *

YES → For holders of the maintenance contract the price of the training is : € Tax free /person

NO → For NOT holding the maintenance contract the price of the training is : € Tax free /person

Would you like to receive a training agreement ? (training organization stated under n° 73.31.04256.31):

YES

NO