CONCORSO INTERNAZIONALE DI MUSICA "CARLO SOLIVA"

Scheda di iscrizione - Sezione pianoforte
Inscription card - Piano section

Cognome .............................................................. Nome ................................................................
(Surname)                                                                                       (Christian name)

Luogo di nascita ........................................................................................ Data ..............................
(Place of birth)                                                                                                                               (Date)

Residente a ................................................................................................Tel ................................
(Address)

Categoria .........................................................................................................................................
(Category)

PROGRAMMA (PROGRAM)

Autore (author)                                            Opera (work)                                Durata (duration)
Prova eliminatoria (eliminatory)
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
Semifinale (semifinal)
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................
Finale (final)
........................................................................................................................................................
........................................................................................................................................................
........................................................................................................................................................

ALLEGATI (enclosures)
a) certificato di nascita od equivalente documento legale
   (a birth certificate or an equivalent official document)
b) vaglia postale di ........... Euro, intestato alla Segreteria del Concorso
   (money-order of ........... Euro, addressed to the secretary's office of the contest)

Data (date)

FIRMA DEL RESPONSABILE ( director's signature)

..................................................................................

(per i minorenni occorre anche la firma del padre o di chi ne fa le veci)
(if under age the parents signature is required)

N.B. qualora fossero necessarie altre schede ciascuno può riprodurle in fotocopia
        (if more forms are required You can fhotocopy them)