FORMULAIRE D'INSCRIPTION pour les nouveaux agents

FORMULAIRE D'INSCRIPTION
pour les nouveaux agents

Nom de naissance : Prénom :

Nom Marital : Date de Naissance : {"name":"DATE_NAISSANCE","value":"","required":true,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

Adresse :

Code Postal : Commune :

Email : Téléphone :

EmployeurCatégorie :

Catégorie :

Statut :

Titulaire Stagiaire Contractuel Autre (à préciser)

Date d'entrée dans la collectivité et fin du contrat (Si fin de contrat connue) :

Début : {"name":"DEBUT_CONTRAT","value":"","required":true,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null} Fin : {"name":"FIN_CONTRAT","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

Composition Familiale :

Nom Prénom Lien de parenté Date de naissance

{"name":"DATE_NAISS1","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS2","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS3","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS4","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS5","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS6","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS7","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

{"name":"DATE_NAISS8","value":"","required":false,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}

Pièces à joindre :

Pour les familles : copie de toutes les pages renseignées de votre livret de famille OU Pour les personnes seules : copie de votre carte d'identité.

{"name":"LIVRET_FAMILLE","label":"Parcourir...","required":true,"typeMimes":{"application\/msword":["doc"],"application\/vnd.openxmlformats-officedocument.wordprocessingml.document":["docx"],"application\/vnd.ms-excel":["xla","xls","xlt","xlw"],"application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet":["xlsx"],"application\/pdf":["pdf"],"application\/x-download":["pdf"],"application\/download":["pdf"],"application\/octet-stream":["pdf"],"application\/octetstream":["pdf"]},"size_max":"10M","multiple":false,"increment":false,"valueIsHtml":true,"label_files":"Parcourir ([total] fichier[s])","id":"6982a8e8ad613","transmit":true,"label_max":"","title":"Le poids d'un fichier \u00e0 transmettre ne peut exc\u00e9der 10M. Les formats de fichier accept\u00e9s sont doc, docx, xla, xls, xlt, xlw, xlsx, pdf.","class":"","value":false,"html":"","initializeJS":true,"minImageSize":false,"square":false,"size_max_byte":10485760,"button":{"value":"Parcourir...","title":"Le poids d'un fichier \u00e0 transmettre ne peut exc\u00e9der 10M. Les formats de fichier accept\u00e9s sont doc, docx, xla, xls, xlt, xlw, xlsx, pdf.","class":"","id":"6982a8e8ad613"}}
Pour tous : copie de votre arrêté de recrutement ou contrat de travail

{"name":"CONTRAT","label":"Parcourir...","required":true,"typeMimes":{"application\/msword":["doc"],"application\/vnd.openxmlformats-officedocument.wordprocessingml.document":["docx"],"application\/vnd.ms-excel":["xla","xls","xlt","xlw"],"application\/vnd.openxmlformats-officedocument.spreadsheetml.sheet":["xlsx"],"application\/pdf":["pdf"],"application\/x-download":["pdf"],"application\/download":["pdf"],"application\/octet-stream":["pdf"],"application\/octetstream":["pdf"]},"size_max":"10M","multiple":false,"increment":false,"valueIsHtml":true,"label_files":"Parcourir ([total] fichier[s])","id":"6982a8e8ae055","transmit":true,"label_max":"","title":"Le poids d'un fichier \u00e0 transmettre ne peut exc\u00e9der 10M. Les formats de fichier accept\u00e9s sont doc, docx, xla, xls, xlt, xlw, xlsx, pdf.","class":"","value":false,"html":"","initializeJS":true,"minImageSize":false,"square":false,"size_max_byte":10485760,"button":{"value":"Parcourir...","title":"Le poids d'un fichier \u00e0 transmettre ne peut exc\u00e9der 10M. Les formats de fichier accept\u00e9s sont doc, docx, xla, xls, xlt, xlw, xlsx, pdf.","class":"","id":"6982a8e8ae055"}}

J’autorise le Cos Normand à recueillir et à traiter mes données à caractère personnel (cette autorisation est obligatoire pour bénéficier des prestations).

J’accepte de recevoir la Newsletter du Cos Normand (restez informés des nouveautés, dates des prestations, informations importantes, etc).

Fait à : Le : {"name":"VALID_DATE","value":"","required":true,"disabled":false,"showTime":false,"rows":1,"cols":1,"title":false,"showDate":true,"preloadCalendar":false,"id":null,"placeholder_date":false,"placeholder_time":false,"size":"","start_id":"","class":"","class-time":"","calendar":{"cols":1,"rows":1,"dateCursor":"pointer"},"valueViewDate":"","valueViewTime":"","formatDate":"d\/m\/Y","formatTime":"H:i","checkDateOnLoad":false,"autocomplete":null}