FORMULAIRE DE DEMANDE
APPLICATION FORM
Prenom (Family
name)________________________________________________
Nome (First
name)___________________________________________________
Sex (Sex)___________________________________________________________
Date et lieu de naissance (Date
and place of birth)_________________________
Citoyennete
(Citizenship)_____________________________________________
L'education musicale (Musical
education)________________________________
___________________________________________________________________
___________________________________________________________________
Les enseignants, s'il vous plait indiquer le nom complet, des distinctions honorifiques (Teachers,
please indicate full name,honorary
awards)___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Participation a des concours, prix (Participation
in competitions, prizes, awards)___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Adresse du domicile avec code postal, telephone, fax, e-mail
(Home
address with postal code, contact telephone, fax, e-mail)___________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
PROGRAMME
(PROGRAM) ___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Je confirme que je suis au courant des conditions du concours
et accepter l'obligation de les remplir.
I hereby confirm that I am aware of the conditions of the competition
and accept the obligation to fulfill them.
Signature____________________________________________________
Date_________________________________________________________