Application Form Personal Data of the Soloist or the Representative of the Ensemble Surname Name Date of Birth Social Security or other ID Code Home Address City County of residence Nationality Please attach copy of ID Card or Passport Contacts E-mail Mobile-phone General Informations Category/ies (A-B-GP) SOLOIST or CHAMBER GROUP I NEED OF AN ACCOMPANIST (PIANIST)* ? NoSi *The contestants who request the accompanist MUST send the music score via email together with the subscription. OTHER MUSICIANS NAMES (ONLY FOR CHAMBER GROUPS CAT. A and GP) Surname, First Name, Date of Birth, Musical Instrument or Voice CONSERVATORY STUDENTS FROM: (Name of the Conservatorium - Only CAT. A) TECHNICAL REQUESTS (A-B-GP) Performance programs Single Round ( 15’ )___ CAT. A or B Eliminatory Round ( 15’ )___CAT. G.P. Final (durata 20’)____CAT G.P. Membership Fee Payment Details Category A 80 €Category B 100 €Category GP(Grand Prize) 100 € Pay with Bank TransferPay with PaypalPay with credit card If you choose mode, of payment by bank transfer, attach the receipt in pdf to the item attachments on: IBAN: IT49 D 08327 15600 000000001181 BIC: ICRAITRRROM , intestation of Associazione Culturale Eleomai IMPORTANT HAVING READ THE RULES AND REGULATIONS OF THE MUSICA ITALIA GRAND PRIZE, FIRST EDITION, THE UNDERSIGNED ON BEHALF OF HIMSELF/HERSELF AND/OR AS REPRESENTATIVE OF AN ENSEMBLE, REQUESTS TO PARTICIPATE, DECLARING THAT HE/SHE ACCEPTS THE RULES AND REGULATIONS AND ALL THE RULES CONTAINED THEREIN, INCLUDING THE JURY'S INDISPUTABILITY. THIS FORM, COMPLETED IN ALL ITS PARTS, IS VALID AS AN ENTRY TO THE MUSICA ITALIA GRAND PRIZE AND MUST BE ACCOMPANIED BY A COPY OF THE RECEIPT OF PAYMENT OF THE ENTRY FEE AND COPIES OF THE COMPETITORS' IDENTITY DOCUMENTS. APPLICATION FAILED WILL NOT BE TAKEN INTO CONSIDERATION. THE UNDERSIGNED, ON HIS/HER OWN BEHALF AND/OR AS REPRESENTATIVE OF AN ENSEMBLE, AUTHORISES THE ORGANISING COMMITTEE TO PROCESS PERSONAL DATA IN ACCORDANCE WITH DGPR N.679/2016 AND THE RELEVANT LAWS IN FORCE. ATTACH ARTISTIC CV WITH PHOTOS - Attachments