Request assistance/training

Are you an educational institution, a professional or a parent? and would you like to benefit from an educational intervention by the e-Enfance Association / 3018?
You are the mayor of your town, a youth representative or a town councillor. and would you like to train your local facilitators in the e-Enfance Association's Programme / 3018 «Internet Superheroes»?
You are a committed company or organisation and you wish to Train your employees on the consequences of screen exposure and use with Déclic Workshops?

Please complete the form below.

This will enable us to review your request and schedule our intervention under the best possible conditions and within the shortest possible time frame.

Please note that the cost of these activities may be covered by the Pass Culture.

Fields marked with an asterisk are required for the form to be sent correctly. Thank you.

To request assistance, please complete all of the fields below. This will enable us to review your request and schedule it at the earliest opportunity, subject to availability.

Address of the establishment

Name of establishment*

Address*

Additional address

Postcode*

Town*

Region*

Country*

Information about the establishment

SIRET number

Type of structure*

REP or REP+*

Yes

Structure*

Public

Private

Nearest railway station*

Project contact person

Title*

Madam

Sir

Name*

First name*

Function*

Email*

Landline telephone*

Mobile phone*

Legal representative

Title*

Madam

Sir

Name*

First name*

Email*

Landline telephone*

Manager

Title

Madam

Sir

Name

First name

Landline telephone

Intervention planning

Application for membership of the e-Enfance Association* / 3018 (Annual membership entitles you to the preferential rate)

Yes

Number of classes/groups*

Class level(s)*

Preferred time periods for interventions*

Additional information

Questionnaire

Have you ever contacted the e-Enfance / 3018* association?

Yes

How did you hear about the e-Enfance / 3018 association?*

Request assistance/training

Please complete the form below.

Address of the establishment

Information about the establishment

Project contact person

Legal representative

Manager

Intervention planning

Questionnaire

Let us work together to combat online harassment and violence!