PRIJAVNICA/REGISTRATION FORM

Naziv programa/Program Title *

Ime i Prezime sudionika/Name & Surname of the Applicant *

Your answer

Umjetničko područje/ Artistic Field *

Glazbena umjetnost (instrument), ples, arhitektura..../Music, Dance, Arhitecture...

Datum rođenja sudionika/ Date of Birth (Applicant's) *

YYYY

Mjesto rođenja/ Place of Birth *

Your answer

Spol/Sex *

Male

Female

OIB/Personal identification number *

Your answer

Prebivalište i adresa stanovanja/Place of residence, current address *

Ulica, broj/Steet, no

Your answer

Poštanski broj/Postal Code *

Your answer

Grad/City *

Your answer

Država/Country *

Your answer

Mobitel/Mobile *

Your answer

E-mail *

Your answer

Broj osobne iskaznice/Passport No. *

Your answer

Datum izdavanja isprave/ Date of issue *

YYYY

Datum isteka valjanosti isprave/ Date of expiry *

YYYY

Izdana od/ Issued by *

Your answer

Razina znanja/Level of knowledge *

1- Početnici, manje od 3 godine poduke / Beginner, less then 3 years of experiance; 2- viši razredi niže i srednja muzička škola i iskusni amateri/ Experienced amateur with more then 3 years of tutoring; 3 - studenti glazbe/ Students preparing for professional carriers: 4- mladi profesionalci /Professional musicians

Izbor prehrane/Meals options: *

Puni pansion/All meals

Doručak/Breakfast only

Ručak/Lunch only

Večera/Dinner only

Doručak + ručak/Breakfast+lunch

Doručak + večera/Breakfast+dinner

Ručak + večera/Lunch +dinner

Bez prehrane/No meals

Vegetarijanski meni/Vegeterian meals *

DA/YES

NE/NO

Required

Posebne napomene/Comments

Informacije na koje biste nam željeli skrenuti pozornost (alergije, bolesti, smještaj roditelja, potreba za instrumentom..)/ Additional details (allergies, illnesses, accommodation for parents, instrument requirement...)

Your answer

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