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3° CONCORSO INTERNAZIONALE DI MUSICA MODERNA “ONDE SONORE”

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3° 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 _______________________

SEZIONE (Section): ___________ CATEGORIA (Category ):___________

STRUMENTO _______________________________________________

Per la SEZIONE III GRUPPI Numero componenti (For the SECTION III 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):

Nome (Name) ______________________________________________

Cognome (Surname)_________________________________________

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

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