Partnership request

Monthly subscription | degressive rate per employee | 25% Tax Credit

1. Company or independent contact details

Company name *

Legal status *

SIRET (14 characters) *

Street *

Postal code *

City *

Professional phone *

Contact email *

2. Relationship manager

Referent name / First name *

Referent position *

Referent phone *

Referent email *

3. Activity domain(s)

Select at least one domain *

4. Description of services

List your proposed services *

Geographical coverage area *

Modalities (at least one) *

Sur site

À domicile

À distance

5. Documents to provide

Kbis (PDF)*

Insurance certificate (PDF)*

Bank details (PDF)*

Price list (PDF)*

6. References & commitments

I accept the partners charter *

I accept the general conditions *

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