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ASSOCIAZIONE CULTURALE
                                                  “LE NUOVE MUSE”
                                                           Via Roma 10
                                                        10064 Villar Pellice
                                              C.F.94549470014     P. IVA 08699270016
                                                         tel. 3393289158


       Seminario di percussioni con Raquy Danziger
                        DARBUKA - TECNICA TURCA - SPLIT HAND TECHNIQUE
                                         domenica 30 settembre 2012

    location: da definire
    orario: 11.00/13.00 - 14.00/16.00
    info: MAX RF +393477142066 - info@maxrf.it

                                   MODULO DI ISCRIZIONE
    Il Sottoscritto
    ________________________________________________________________________


    DICHIARA la partecipazione al Seminario di percussioni con Raquy Danziger che si terrà a Torino il
    30 settembre 2012, organizzato dall’ Associazione Culturale “Le Nuove Muse” del/della
    Signore/Signora:

DATI ALLIEVO
                                                                                         L’allievo partecipa al seminario
Nome:_______________________________________________________                             in qualità di:
                                                                                         (indicare con una croce)
Cognome:____________________________________________________
                                                                                                 Partecipante
                                                                                                 €60,00* (costo comprensivo quota
Luogo e Data di Nascita :________________________________________                                associativa minima)

Residenza (Città, Indirizzo, CAP):
                                                                                                 Uditore
_____________________________________________________________                                    €30,00** (costo comprensivo
                                                                                                 quota associativa minima)
Recapito Telefonico :____________________________________________

E-mail: _______________________________________________________                          * €50,00 per chi si è iscritto entro il 15
                                                                                         luglio
                                                                                         ** €25,00 per chi si è iscritto entro il 15
                                                                                         luglio



                                                 SI IMPEGNA
    a versare la Quota di Iscrizione con Bonifico Bancario alle seguenti coordinate bancarie:
    CODICE IBAN: IT 92 F 02008 31070 000020059497

    Data ______________________________


   Informativa per la tutela della privacy (Legge 675/96 art.10). I dati indicati saranno oggetto di trattamenti informatici o
   manuali esclusivamente nell’ambito della virtualità. Il trattamento sarà sviluppato in modo da garantire la riservatezza e
   la sicurezza. È esclusa la diffusione a terzi. I diritti dell’inrteressato sono quelli della citata Legge.

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Modulo iscrizione seminario

  • 1. ASSOCIAZIONE CULTURALE “LE NUOVE MUSE” Via Roma 10 10064 Villar Pellice C.F.94549470014 P. IVA 08699270016 tel. 3393289158 Seminario di percussioni con Raquy Danziger DARBUKA - TECNICA TURCA - SPLIT HAND TECHNIQUE domenica 30 settembre 2012 location: da definire orario: 11.00/13.00 - 14.00/16.00 info: MAX RF +393477142066 - info@maxrf.it MODULO DI ISCRIZIONE Il Sottoscritto ________________________________________________________________________ DICHIARA la partecipazione al Seminario di percussioni con Raquy Danziger che si terrà a Torino il 30 settembre 2012, organizzato dall’ Associazione Culturale “Le Nuove Muse” del/della Signore/Signora: DATI ALLIEVO L’allievo partecipa al seminario Nome:_______________________________________________________ in qualità di: (indicare con una croce) Cognome:____________________________________________________ Partecipante €60,00* (costo comprensivo quota Luogo e Data di Nascita :________________________________________ associativa minima) Residenza (Città, Indirizzo, CAP): Uditore _____________________________________________________________ €30,00** (costo comprensivo quota associativa minima) Recapito Telefonico :____________________________________________ E-mail: _______________________________________________________ * €50,00 per chi si è iscritto entro il 15 luglio ** €25,00 per chi si è iscritto entro il 15 luglio SI IMPEGNA a versare la Quota di Iscrizione con Bonifico Bancario alle seguenti coordinate bancarie: CODICE IBAN: IT 92 F 02008 31070 000020059497 Data ______________________________ Informativa per la tutela della privacy (Legge 675/96 art.10). I dati indicati saranno oggetto di trattamenti informatici o manuali esclusivamente nell’ambito della virtualità. Il trattamento sarà sviluppato in modo da garantire la riservatezza e la sicurezza. È esclusa la diffusione a terzi. I diritti dell’inrteressato sono quelli della citata Legge.