Application Form
3° Concorso di Canto Lirico “Franca Mattiucci” 2013
Surname e Name ……………………………………………………………………….
Vocal Register………………………………………………....................................
Place and Date of Birth……………………………………………………………………
Nationality ………………………………………………………………………………
Address ………………………………………………………………………………..
City,State, Postcode………………………………………………………………………
Telephone Number……………………………………………………………………….
Email…………………………………………………………………………………….
ARIAS (composer, title of aria, opera)
1………………………………………………………………………………………..
2………………………………………………………………………………………..
3………………………………………………………………………………………...
4……………………………………………………………...…………………………
Pianist of Contest:
YES
NO
(bar)
___________________________________________________________________________________________________________
Associazione Musicale Coccia
Sede Legale Viale Indipendenza 38, 14053 Canelli (AT)
Tel. 3384527287 Fax 0141099060
Codice Fiscale 91012190053
www.associazionemusicalecoccia.it
I agree fully the provisions of these Regulations.
Date..........................
Signature………………………..
I attach to this application
a. Complited application form;
b. A copy of a valid identity card or passport;
c. A CV specifying candidate's artistic activities;
d. A copy of payment of the enrolment fee of € 65. Payment of the fee shall be payable to
Associazione Musicale Coccia IBAN IT26F0608547300000000029782 BIC/SWIFT
CASRIT22 - Banca C.R. Asti (indicating Concorso Mattiucci 2011)
e. Photo;
Authorization / consent to the processing of Personal Information
Name………………………………………………………………………………………………
AUTHORIZED
the processing of personal data, to be held in accordance with what stated in the Rules of the Contest and in
accordance with the provisions of the law.
Date……………..
Signature……………………………
___________________________________________________________________________________________________________
Associazione Musicale Coccia
Sede Legale Viale Indipendenza 38, 14053 Canelli (AT)
Tel. 3384527287 Fax 0141099060
Codice Fiscale 91012190053
www.associazionemusicalecoccia.it
