{"id":135,"date":"2026-06-23T20:25:50","date_gmt":"2026-06-23T20:25:50","guid":{"rendered":"https:\/\/www.berlio.fr\/index.php\/bulletin-dinscription-formulaire-2\/"},"modified":"2026-06-24T11:27:06","modified_gmt":"2026-06-24T11:27:06","slug":"bulletin-dinscription-formulaire-2","status":"publish","type":"page","link":"https:\/\/www.berlio.fr\/index.php\/bulletin-dinscription-formulaire-2\/","title":{"rendered":"Bulletin d&rsquo;inscription &#8211; Formulaire"},"content":{"rendered":"\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">Derni\u00e8re mise \u00e0 jour : 23 juin 2026<\/p>\n\n\n<h1 class=\"wp-block-heading\">Bulletin d&#039;inscription<\/h1>\n\n\n<p class=\"has-background wp-block-paragraph\" style=\"background-color: rgb(231, 243, 248)\">&#x1f4e7; <strong>\u00c0 retourner par email \u00e0<\/strong> : <a href=\"mailto:patrice.laurent@berlio.fr\">patrice.laurent@berlio.fr<\/a><\/p>\n\n\n<h2 class=\"wp-block-heading\">Formation souhait\u00e9e<\/h2>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Nom de la formation<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Date<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Lieu<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Horaires<\/strong> : 8h30-12h00 \/ 13h30-17h00<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Effectif<\/strong> : 5 participants minimum \/ 12 participants maximum<\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n<h2 class=\"wp-block-heading\">Informations entreprise<\/h2>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Raison sociale<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Nom et pr\u00e9nom du responsable<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Adresse compl\u00e8te<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Code postal<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026  <strong>Ville<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>T\u00e9l\u00e9phone<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026  <strong>Email<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Activit\u00e9 de l&#039;entreprise<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Nombre de salari\u00e9s<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>N\u00b0 SIRET<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026  <strong>Code APE<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n<h2 class=\"wp-block-heading\">Informations stagiaire<\/h2>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Nom et pr\u00e9nom<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Date de naissance<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Profession<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n<h2 class=\"wp-block-heading\">Tarif de la formation<\/h2>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Co\u00fbt de la formation<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026 \u20ac TTC<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><em>(Non assujetti \u00e0 la TVA au titre de la formation professionnelle)<\/em><\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n<h2 class=\"wp-block-heading\">Protection des donn\u00e9es personnelles (RGPD)<\/h2>\n\n\n<p class=\"has-background wp-block-paragraph\" style=\"background-color: rgb(231, 243, 248)\">&#x1f512; <strong>Vos donn\u00e9es sont prot\u00e9g\u00e9es<\/strong><\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">Conform\u00e9ment au R\u00e8glement G\u00e9n\u00e9ral sur la Protection des Donn\u00e9es (RGPD) et \u00e0 la loi \u00ab Informatique et Libert\u00e9s \u00bb, nous vous informons sur le traitement de vos donn\u00e9es personnelles.<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Responsable du traitement<\/strong> : BERLIO &#8211; Patrice LAURENT<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Contact<\/strong> : <a href=\"mailto:patrice.laurent@berlio.fr\">patrice.laurent@berlio.fr<\/a> &#8211; 06.66.54.18.54<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Finalit\u00e9 du traitement<\/strong> : Les donn\u00e9es collect\u00e9es sont utilis\u00e9es exclusivement pour :<\/p>\n\n\n<ul class=\"wp-block-list\">\n<li>La gestion administrative de votre inscription<\/li>\n\n\n\n<li>L&#039;\u00e9tablissement de la convention de formation<\/li>\n\n\n\n<li>La facturation et le suivi comptable<\/li>\n\n\n\n<li>La d\u00e9livrance des documents de fin de formation<\/li>\n\n\n\n<li>Le respect des obligations l\u00e9gales (conservation des documents de formation)<\/li>\n<\/ul>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Donn\u00e9es collect\u00e9es<\/strong> : Informations entreprise (raison sociale, SIRET, coordonn\u00e9es), informations stagiaire (nom, pr\u00e9nom, date de naissance, profession).<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Dur\u00e9e de conservation<\/strong> : Vos donn\u00e9es sont conserv\u00e9es pendant <strong>3 ans<\/strong> apr\u00e8s la fin de la formation, puis archiv\u00e9es conform\u00e9ment aux obligations l\u00e9gales.<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Vos droits<\/strong> : Conform\u00e9ment aux articles 15 \u00e0 22 du RGPD, vous disposez d&#039;un droit d&#039;acc\u00e8s, de rectification, d&#039;effacement, de limitation du traitement, d&#039;opposition et de portabilit\u00e9 de vos donn\u00e9es.<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">Pour exercer ces droits, contactez : <a href=\"mailto:patrice.laurent@berlio.fr\">patrice.laurent@berlio.fr<\/a><\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>R\u00e9clamation<\/strong> : Vous pouvez introduire une r\u00e9clamation aupr\u00e8s de la CNIL (<a href=\"http:\/\/www.cnil.fr\/\">www.cnil.fr<\/a>).<\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n<h2 class=\"wp-block-heading\">Engagements<\/h2>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Je certifie avoir :<\/strong><\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">\u2610 Pris connaissance du programme de formation<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">\u2610 V\u00e9rifi\u00e9 l&#039;ad\u00e9quation de la formation avec mes besoins (contact par mail ou t\u00e9l\u00e9phonique)<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">\u2610 Contact\u00e9 BERLIO pour toute question ou clarification (demande d\u2019adaptation)<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">\u2610 Fait r\u00e9pondre le stagiaire au questionnaire de positionnement (si demand\u00e9)<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">\u2610 Pris connaissance et accept\u00e9 les Conditions G\u00e9n\u00e9rales de Vente<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Consentement RGPD :<\/strong><\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">\u2610 <strong>J&#039;autorise BERLIO \u00e0 traiter les donn\u00e9es personnelles<\/strong> figurant sur ce bulletin aux fins de gestion de la formation, et j&#039;ai pris connaissance de mes droits d&#039;acc\u00e8s, de rectification et d&#039;opposition.<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">&nbsp;<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Date<\/strong> : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\"><strong>Signature et cachet de l&#039;entreprise<\/strong> :<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">&nbsp;<\/p>\n\n\n<p class=\"has-text-color wp-block-paragraph\" style=\"color: rgb(0, 0, 0)\">&nbsp;<\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n\n<p class=\"has-background wp-block-paragraph\" style=\"background-color: rgb(241, 241, 239)\">&#x1f4a1; <strong>Pour toute question<\/strong> : Patrice LAURENT &#8211; 06.66.54.18.54 &#8211; <a href=\"mailto:patrice.laurent@berlio.fr\">patrice.laurent@berlio.fr<\/a><\/p>\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity is-style-wide\"\/>\n\n","protected":false},"excerpt":{"rendered":"<p>Derni\u00e8re mise \u00e0 jour : 23 juin 2026 Bulletin d&#039;inscription &#x1f4e7; \u00c0 retourner par email \u00e0 : patrice.laurent@berlio.fr Formation souhait\u00e9e Nom de la formation : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 Date : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 Lieu : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 Horaires : 8h30-12h00 \/ 13h30-17h00 Effectif : 5 participants minimum \/ 12 participants maximum Informations entreprise Raison sociale : \u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026\u2026 Nom et pr\u00e9nom&#8230;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"_kad_post_classname":"","footnotes":""},"class_list":["post-135","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/pages\/135","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/comments?post=135"}],"version-history":[{"count":2,"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/pages\/135\/revisions"}],"predecessor-version":[{"id":153,"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/pages\/135\/revisions\/153"}],"wp:attachment":[{"href":"https:\/\/www.berlio.fr\/index.php\/wp-json\/wp\/v2\/media?parent=135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}