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6 ° CONCORSO INTERNAZIONALE DI MUSICA MODERNA

“ONDE SONORE”

SCHEDA DI ISCRIZIONE Si prega di scrivere in stampatello (APPLICATION FORM) (Please write in capital letters) Nome (Name) Cognome (Surname)

Luogo di nascita (Place of birth) Data di Nascita (Date of birth) Nazionalità (Nationality)

Indirizzo (Address)

CAP (Postal code) Città (Country)

Tel.(Phone) E-mail

Codice Fiscale* (concorrente solista) :________________________________________

Codice Fiscale* (della persona che ha effettuato il bonifico) :______________________

*solo per concorrenti di cittadinanza italiana, only for Italian competitors SEZIONE (Section) : _________ CATEGORIA (Category) :_________

STRUMENTO (Instrument) :_______________________________________________

Per la SEZIONE V GRUPPI Numero componenti: ______________________________

(For the SECTION V GROUP Number components) : ____________________________

Indicare il nome e cognome dei componenti del gruppo (Name and surname of each components):_____________________________________________________________

________________________________________________________________________

________________________________________________________________________

PROGRAMMA autore, titolo e minuti (PROGRAM author, title and duration in

minutes ) : ______________________________________________________________

________________________________________________________________________

INSEGNANTE (Teacher)

Cognome (Surname) Nome (Name) Indirizzo (Address)

CAP (Postal code) Città (Country) Tel (Phone) e-mail

Dichiaro di accettare integralmente le norme del Bando di Concorso (I state to agree with the contest rules).

Data (Date) Firma del concorrente (Applicant’s Segnature)

per i minori firma di un genitore o facente funzione (for applicants under 18 a legal tutor

______________________________________

Firma dell’insegnante (Teacher’s Segnature)___________________________________

Allegati : vedi art. 6

(I enclose : photocopy of an identità certificate, photocopy of Bankpayment of application fee)

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