APPLICATION FORM

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SURNAME________________________________________________________________

FIRST NAME_____________________________________________________________

PLACE AND DATE OF BIRTH______________________________________________

ADDRESS OF RESIDENCE_________________________________________________

STREET__________________________________________________________________

TOWN_______________________________________ZIPCODE____________________

DISTRICT_____________________________________COUNTRY_________________

FISCAL CODE_____________________________________________________________

PHONE____________________________________________________________________

EMAIL____________________________________________________________________

I enclose:

1) Curriculum Vitae ;
2) List of the select composition for the tests;
3) Two fotos (card-photos);
4) photocopy of the receipt of the payment of the tax of registration (the amount is 87 euros and it is not reimbursable) on the cheque N.T. or on the postal current headed to: Fabio Di Lella, Via Francesco Landino,15 - 00124 Roma (RM) Italy, account number IBAN CODE: IT 70 C 07601 03200 000022367007 -
SWIFT code: b p p i i t r r x x x     BANK: BANCOPOSTA
BIC Code: p o s o i t 2 2 x x x         (this code only from USA)

I accept inconditionally the regulations of the competition.

Date___________________

Signature_________________________________________

For the minor it also needs the signature of one of his parents

The reception office: International Flute Competition "Domenico Cimarosa"
Via Francesco Landino, 15 - 00124 Roma (RM) Italia
Tel.+39.347.9199126 - Fax +39.081.8118436