Programme AvantAge - Registration inter-company preparing for retirement

Preparing for retirement : registration for the inter-company seminar

WARNING : this form adapts to your answers.

Registration form

Date * (Geneva)
date*
- next date to be defined
English seminar in Geneva
Prix 2021 (2 days) : CHF 520 for a single person and CHF 900 for a couple
Contact details
Surname Name*
Surname * Name *
Address*
Private address * Postal code - City *
Landline*
Mobile number
Business phone number
Date of birth*
JJ - MM - AAAA
Occupation
Job function
Employer
Professionnal e-mail address*

Please indicate your professionnal e-mail address (for correspondence)
Private e-mail address
To receive information and special offers from AvantAge and Pro Senectute, please indicate your private e-mail address
Add participants *
Add participants*
- Yes
- No
Number of additional participants*
Veuillez saisir un nombre entre 1 et 10.
You can add 10 additional participants max
Additional participants' contact details*
For each additional participants, please indicate the following contact details : Surname, Name, Private address, Postal code - City, Landline phone number, Date of birth, E-mail.
The seminar will be paid by your employer *
The seminar will be paid by your employer*
- Yes
- No
Employer's contact details (Management/HR)
Company name*
Address*
Address * Postal code - City *
Surname Name*
Surname (point of contact) * Name (point of contact) *
E-mail address*
Phone number*
If you intend to participate with your partner, please make sure your company will also pay for their participation
Different billing address *
Different billing address*
- Yes
- No
Company name*
Address*
Address Postal code - City
Billing reference
*
- I agree that my information be used to contact me