Wording On An Invitation For A Dutch Meal

EXAMPLE FORM

(put a cross on the section you wish to attend)

___ Visual Arts

___ Performer

___ Band

___ Dj

\\ the undersigned \\ i NAME __________________________________________________ NAME ______________________________________________ BIRTH _________________________________________________ IL______________________________________________________ RESIDENT A (common )____________________________________ PROVINCIA_________________________CAP_________________ IN __________________________________________________ E-MAIL__________________________________________________ PHONE ______________________________________________ CELLULARE______________________________________________ INDICATE IF ENTERED SIAE _________________________________________________________

ONLY VOCAL GROUP: GROUP NAME :________________________________________ NAME OF GROUP MEMBERS : INDICATE IF ENTERED SIAE

asks to participate in the "Stramonium Art Festival" and declare their own responsibility:

· have read and to approve the rules of the competition in every article;

· undertake to respect all the provisions of Regulation ;

· to annex the requested material;

· have read the provisions of the Regulation on the processing of personal data.

Date Signature

______ / _____ / ________ __________________________________

Signature (required)