Application form XENIA COURSE 2018

Name Surname Sex

Place of birth Date of birth

Full address n. postal code

city/province country

Phone number E-mail

Instrument  violin viola cello

Grade

Conservatoire, Music college

Teacher

For members of pre-formed groups (€125 discount on application fee of each member)
name of group attending the course

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 21st International Chamber Music Course to be held at Pra Catinat, Fenestrelle (Italy), from July 26th to august 5th 2018. 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.

Attach audio file

I WISH TO APPLY TO THE 21st 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.