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A P P L IC A T I O N F O R M
Name Family name Nazionality Place and date of birth . Address Tel.: Fax.: e-mail: . Program: -first round: A) . B) . -second round: A) . B) . - final round: A)Tschajkowskij : Variations on a Rococς theme op. 33B) Haydn: A pianist is required yes no Enclosed: bank transfer receipt Date ....... Signature . Send by priority mail to: Associazione Culturale Il Ventaglio, Via Clemente X, 4 - 00167 Roma RM Please forward application in advance by fax:: (39/06) 65002715 or by e-mail: info@ilventaglio.net ATT: no "on-line" application! You can print this form and send it according to the given rules. back to: Premio Arturo Bonucci (home) |