Registration to Masterclass Anacapri 2017

Fill in the form to partecipate to Masterclass Anacapri 2017. Detailed instructions here.

*required fields

Name*

Email*

Id Number (Passport of other document)*

Surname*

M/F*
MF

Birthdate*

Birthplace*

Address*

City*

Postal Code*

Country*

Phone*

Instrument*

Course*

Academy of Music, Conservatoire (current or past)*

Qualification*

I SUBSCRIBE TO

The Masterclass of prof.*

As:*

Arrival date*

Departure date*

Payment receipt* (PDF format - max dimension 2MB)

Curriculum Vitae* (PDF format - max dimension 2MB)

Passport Photo* (JPG format - max dimension 1MB)

Money Bank Transfer no*

Repertoire to play*

Piece for the student concert*

Score for the accompanist (PDF format - max dimension 2MB)

ACCOMODATION

I need support for the accomodation (subject to availability)I'll do by myself

Privacy

I hereby authorize the use of my personal details solely for activities of Association Concertato and within the Masterclass In accordance with the Italian regulations D.Lgs.196/03.
Con la presente si autorizza l’Associazione Concertato ad utilizzare ai sensi del D.Lgs. 196/03 (“tutela della privacy”), I suddetti dati personali solo ed esclusivamente per finalità istituzionali connesse o strumentali alle attività dell’Associazione Concertato.
Dichiaro di essere a conoscenza del trattamento dei dati personali indicati dal D.Lgs 196/03.

I Accept*