Adhérer à la CPTS

Information adhérent
Prénom*
Nom*
Profession*
E-mail professionnel*
Téléphone professionnel
Username d-none*
Mot de passe*
Répéter votre mot de passe*
Je déclare par la présente souhaiter devenir membre de la CPTS.*
A ce titre, je déclare reconnaître l'objet de l'institution, et en avoir accepté les statuts. (Merci de contacter la CPTS pour lire les statuts)*
Je certifie être couvert par une assurance RC professionnelle.*
J'ai pris bonne note des droits et des devoirs des membres de l'association, et accepte de verser ma cotisation due pour l'année en cours.*
Montant des cotisations (cotisation annuelle)
Adhésion - 10 € jusqu’au 31 décembre 2024

Billing Details
Billing First Name*
Billing Last Name*
Billing Email*
Billing Company
If entered, this will appear on the invoice, replacing the First and Last Name.
Billing Address*
Billing City*
Billing Zip / Postal Code
Billing Country*
Billing State / Province

Cookie	Type	Duration	Description
__stripe_mid		1 year	Stripe sets this cookie cookie to process payments.
__stripe_sid		30 minutes	Stripe sets this cookie cookie to process payments.
cookielawinfo-checkbox-necessary	0	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-non-necessary	0	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Non Necessary".
CookieLawInfoConsent		1 year	Records the default button state of the corresponding category & the status of CCPA. It works only in coordination with the primary cookie.
viewed_cookie_policy	0	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

Cookie	Duration	Description
VISITOR_INFO1_LIVE	5 months 27 days	A cookie set by YouTube to measure bandwidth that determines whether the user gets the new or old player interface.
YSC	session	YSC cookie is set by Youtube and is used to track the views of embedded videos on Youtube pages.
yt-remote-connected-devices	never	YouTube sets this cookie to store the video preferences of the user using embedded YouTube video.
yt-remote-device-id	never	YouTube sets this cookie to store the video preferences of the user using embedded YouTube video.
yt.innertube::nextId	never	This cookie, set by YouTube, registers a unique ID to store data on what videos from YouTube the user has seen.
yt.innertube::requests	never	This cookie, set by YouTube, registers a unique ID to store data on what videos from YouTube the user has seen.

Cookie	Duration	Description
DEVICE_INFO	5 months 27 days	No description
m	2 years	No description available.

Information adhérent