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Phone: +33 (0)3.20.06.17.30 | Email: admin@eclee.eu

On-Site Registration Form

Complete the form below to register for ECLEE programs

1 Personal Information

ECLEE Student Number

Gender *

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Date of Birth *

Last Name *

First Name *

Middle Name

2 Contact Information

Address *

City *

State/Region

ZIP Code *

Cellular Telephone

Office Telephone

Email Address *

3 Course Information

Select Course(s) *

Lean Six Sigma Yellow Belt Lean Six Sigma Green Belt Lean+ Lean Six Sigma Black Belt Lean Engineering Business Model Canvas Design Thinking Lean Startup Leadership Diamond® Lean Healthcare YETI-EU Digital Marketing Landing a Job SCRUM

Other Course (if not listed above)

Course Mode

Onsite Online

Course Language

French English

4 Previous Enrollment

Have you ever enrolled for non-credit courses at ECLEE?

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Have you ever enrolled for credit courses at ECLEE?

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Have you applied for Non-matric status at ECLEE?

Yes No

Are you currently on drop status for low scholarship?

Yes No

Are you a high school student?

Yes No

Are you a jobseeker?

Yes No

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