Application form XENIA COURSE 2021

Name Surname Sex

Place of birth Date of birth

Full address n. postal code

city/province country

Phone number E-mail

Instrument violinviolacello

Grade

Conservatoire, Music college

Teacher

For ex pupils (€50 discount on your application fee)
name of new student that is applying on your recommendation

For the second family member (€100 discount on your application fee)
name of the brother/sister attending the course

FOR UNDERAGE STUDENTS ONLY
I (name and surname)
undersigned parent or legal guardian, give permission for my child to take part in any public concert connected with the 24th International Chamber Music Course from July 25th to August 1st 2021. We are aware that these concerts are part of the Course's teaching programme and consequently neither fee nor travel expenses will be paid to our child.
I also consent to the participation in photographs and video for nonprofit purposes by the Ensemble Xenia Association. If by July 10th the existing or new regional and national decrees in force will not allow the course to take place, then applicants will have their deposits returned

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I WISH TO APPLY TO THE 24rd XENIA CHAMBER MUSIC COURSE*

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*Sending this form you authorize the use of all personal data provided as stated by Italian Law 196/03.

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