Ticino Musica

Enrollment form 2010

Please, fill in the following form in all its parts.

Personal data: Name
Surname
Address
ZIP and City
Country
Phone
Fax
Email
Date of birth
Sex
Nationality
Choosen Course (arr. 19.07 / dep. 31.07/1.08.2010): Course
Partecipation
Complementary courses:

Free of charge for participants to other TICINO MUSICA courses 2010

Chamber music

for strings
with piano
for woodwinds
mixed ensembles
for brass
for wind ensembles
for symphonic orchestra
Costi:

Active participant:
– Course & Lodging: CHF / ca. €
– Only course: CHF / ca. €

Observer:
– Course & Lodging: CHF / ca. €
– Only course: CHF / ca. €

Accommodation: course and lodging in hostel I want to share the room with:
only course
course and lodging in hotel
Payment: Calculate the total:

____ CHF (ca. ____ € )

The enrollment is confirmed only after the payment of the deposit (CHF 300.- / ca. € 200.-) or of the whole fee.

I'm paying the
Way of payment

Supported credit cards: VISA e Master Card.

Cheque to:

Ticino Musica
Casella postale 722
CH - 6903 Lugano

Bank transfer to:

BANCA DELLO STATO DEL CANTONE TICINO
6501 Bellinzona
SWIFT BSCTCH22
SIC/Clearing 764
Conto n. 4267662/001.000.001
IBAN CH69007644267662C000C

Info: I heard about TICINO MUSICA from :
Date
Notes

I have read the Terms of partecipation and I accept them

For information:

Ticino Musica
Casella postale 722
CH-6903 Lugano

Tel. +41 (0)91 980 09 72
Fax. +41 (0)91 980 09 71

ticinomusica@bluewin.ch