application form
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application form
VI Międzynarodowy Konkurs Muzyki Kameralnej im. Johannesa Brahmsa 6th International Johannes Brahms Chamber Music Competition KARTA ZGŁOSZENIA / ENTRY FORM Kategoria / Category ................................................................................................. Nazwa zespołu / Name of ensemble................................................................................................ Członkowie zespołu / Members : Nazwisko Name 1 2 3 4 Imię First name Data urodzenia Date of birth Instrument Adres (tel., fax, e-mail) Address (phone number, e-mail) Narodowość Nationality Mężczyzna/Kobieta Male / Female PROGRAM / PROGRAMME I etap – 1. round – 1. …………………………………………………………………………………….. 2. ……………………………………………………………………………………... II etap – 2. round – 1. …………………………………………………………………………………….. 2. ……………………………………………………………………………………... Krótka informacja o zespole / Brief information on group ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... ...................................................................................................................................................................................................................................................... Data / Date .............................................. Podpisy / Signatures ................................................................ ................................................................ ................................................................ ................................................................