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| Name/Surname |
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Place and Date of Birth : |
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| School/Class |
: |
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| School Address/Phone Number |
: |
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| Trainer Teacher’s name and phone number |
: |
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| Trainer Teacher’s Address |
: |
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| Work(s) which will be played |
: |
| Name of the work |
Composer |
Total Time |
| 1 - |
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1 - |
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1 - |
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| 2 - |
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2 - |
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2 - |
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| 3 - |
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3 - |
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3 - |
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| 4 - |
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4 - |
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4 - |
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| I attend to the festival for the first time |
: |
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I’ ve attended to Pera Piano Festival before |
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| Home Address |
: |
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| City/Province |
: |
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| Home Phone Number/Mobile Phone number |
: |
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E-Mail : |
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| Father’s Name, Surname, Job and Phone number |
: |
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| Mother’s Name, Surname, Job and Phone number |
: |
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Parent’s |
Student’s |
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| Name/Surname |
: |
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| Signature |
: |
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| * Pay attention to fill in the form completely and legible. Incomplete and/or illegible forms will be disregarded. |
| ** The parents will sign the application form of the applicants under the age of 18. |
| *** Application form should be conveyed to the address below by hand or post mail with the attachments required in “Application Specification” by 14 March 2010 |
|
| Address : Özel Pera Güzel Sanatlar Lisesi |
| Sıraselviler Cad. Billurcu Sok. Billurcu Çıkmazı No:10 Taksim 34433 - İSTANBUL |
| E-Mail : pera@peraguzelsanatlar.com.tr |
| Phone : 0 212 245 44 60- 245 30 08 - 245 30 09(pbx) |
| Fax : 0 212 252 30 82 |