International piano competition "Musica Aeterna"

Application fee: 80 Euros
to be paid before May 31, 2007
on the account of Musica Aeterna asbl-Belgique
IBAN: BE39 3101 3371 7519 - BIC: BBRUBEBB
Bank taxes in charge of participant

Only candidates who have paid application fee will be playing

Application form/Formulaire d'inscription
Form to be filled before May 31, 2007
you may also print it and fax to +32(0)23800827
or post to "Musica Aeterna" , Lotsesteenweg, 186, B-1653 DWORP

Surname/Nom
Name/Prénom
Date and place of birth Date et lieu de naissance:
Gender/sexe:
Nationality/Nationalité
Address: Street/Rue Zip code/code postal City/Ville Country/Pays
Telephone
Fax:
Mobil/GSM:
e-mail:
Education (evt):
Teacher/Professeur
Hotel needed:	oui non
- I pay the application fees of 80€ on the account of Musica Aeterna, as mentionned at the top of this page.