Application questionnaire: COLEACP digital training support (thematics)

First name and Surname *

Date of birth *

Month

Day

Year

E-mail *

Country *

What is your level of skill with the following tools? *

	None	Beginner	Average	Advanced	Expert
Moodle *	Moodle - None	Moodle - Beginner	Moodle - Average	Moodle - Advanced	Moodle - Expert
Camtasia *	Camtasia - None	Camtasia - Beginner	Camtasia - Average	Camtasia - Advanced	Camtasia - Expert
Zoom *	Zoom - None	Zoom - Beginner	Zoom - Average	Zoom - Advanced	Zoom - Expert
Powerpoint *	Powerpoint - None	Powerpoint - Beginner	Powerpoint - Average	Powerpoint - Advanced	Powerpoint - Expert
Youtube *	Youtube - None	Youtube - Beginner	Youtube - Average	Youtube - Advanced	Youtube - Expert

The requested information must be collected in order to process your request. The information provided is reserved for the exclusive use of COLEACP and will never by passed on to third parties. As part of managing our contacts, we retain the personal data linked to them for up to 3 years after the most recent contact. You have a right of access, to rectification, to object and to erasure of your personal data. To exercise this right, contact us via email or send us a letter stating your email address to: COLEACP 5 rue de la Corderie - Centra 342 94586 Rungis Cedex France. We will respond to you within one month. If you feel that your rights have been infringed, or if we do not reply, you are entitled to file a complaint to the CNIL (data protection authority). CNIL Declaration No 1359145.

What color was Henry IV white horse? *

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Application questionnaire: COLEACP digital training support (thematics)