preliminary application for the admission to the selection procedure

PRELIMINARY APPLICATION FOR THE ADMISSION TO THE SELECTION
PROCEDURE FOR BAROQUE MUSIC MASTER CLASSES - YEAR 2016
The undersigned - First Name and Last Name: _______________________________
Place and Date of Birth: __________________________________________
Fiscal Code: _________________________________________________
Permanent Address: ____________________________________________
ZIP Code:
______ City: __________________________________ State/Province: ____
Mailing Address (if different from Permanent Address): ______________________
_____________________________________________ ZIP Code: ______
City: __________________________________ State/Province: ____
Phone Number: _____________________________________________
Other Phone Number: _________________________________________
E-mail Address: _______________________________________________________
Qualification: _________________________________________________
Instrument: ____________________________________________________
I ask to be admitted to the selection procedure to participate to the activities of the following Master Class:

Baroque Singing with Romina Basso, Sept. 9th-14th

Baroque Singing with Elena Cecchi Fedi, Sept. 9th-14th

Baroque Violin with Alessandro Ciccolini, Sept. 9th-14th

Baroque Violin and Viola with Luca Giardini, Sept. 5th-10th

Baroque Cello with Mauro Valli, Sept. 9th-14th

Viola da Gamba with Rosita Ippolito, Sept. 9th-14th

Archlute, Lute, Baroque Guitar and Theorbo with Diego Cantalupi, Sept. 9th-14th

Baroque Oboe with Paolo Pollastri, Sept. 9th-14th

Baroque Trumpet with Jonathan Pia, Sept. 9th-14th

Harpsichord and Basso Continuo with Daniele Proni, Sept. 9th-14th
Date
_______________
Signature (legible) ______________________
In compliance with the Italian Legislative Decree no. 196 dated 30/06/2003, I hereby authorize the recipient of this document – the Direction
of the Accademia Filarmonica di Bologna – to use and process my personal details for the purposes related to the management of the Course
and I confirm to be informed of my rights in accordance to art. 7 of the above mentioned decree.
Firma
_________________________