ENROLMENT FORMULAR
PERSONAL INFORMATION:
name:
first name:
sex:
male
female
date of birth (dd.mm.yyyy):
nationality (international abreviation):
street:
postcode:
city:
state (international abreviation):
telephon:
mobile phone:
fax:
e-mail:
MUSICAL STUDIES:
INSTRUMENT:
violin
viola
violoncello
piano
other instrument:
prefered teacher:
--- please select ---
Christos Polyzoides (violin & viola)
Margherita Marseglia (violin)
Elisabeth Polyzoides-Baich (violin)
Demetrius Polyzoides (violin)
Georg Hamann (viola)
Klaus Marx (violoncello)
Katherina Polyzoides-Survali (piano)
Janna Polyzoides (piano)
second teacher:
--- please select ---
Christos Polyzoides (violin & viola)
Margherita Marseglia (violin)
Elisabeth Polyzoides-Baich (violin)
Demetrius Polyzoides (violin)
Georg Hamann (viola)
Katherina Polyzoides-Survali (piano)
Janna Polyzoides (piano)
if the first professor is occupied (not for cellists)
Which works did you prepare for the solo course?
REGISTRATION FOR CHAMBER MUSIC:
yes
no
if no, please go to
accommodation
No further course fee.
names of the group members:
complete list of works and there instrumentation:
ACCOMMODATION
single room
double room
triples
for double and triple rooms: Whom do you want to share a room with?
other
help to this
Please check your personal datas because we can't consider incomplete or nonsensical forms.
I read the regulations of participation and I agree with them!
Please transfer the registration fee up to 9
th
of July the latest to the following bank account:
Raiffeisenbank Region Bad Leonfelden
account number: 55152
bank code number: 34277
IBAN (international bank code): AT48 3427 7000 0005 5152
BIC No: RZOOAT2L277