ZAŁĄCZNIK 1 „My musical inspirations.” The sixteenth edition of the International Competition APPLICATION FORM 1. The band's name or the names of the students (instrument) / age, group ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... .................................................................................................................................................................. 2 Name and address of school................................................................................................................ ................................................................................................................................................................. 4. Name and surname of teacher, telephone number, e-mail ............................................................................................................................. ……………………………………………………………………………………………………………………………………………………………. 5. Program............................................................................................................................................ ............................................................................................................................................................... ............................................................................................................................................................... ............................................................................................................................................................... 6 Expected duration of the program…………………………………................................................................ 7. Booking dinners, accommodation…./pcs.... ….... …......................................................... Signature of teacher Date and signature of a headmaster of school …………………………………….................................... ( stamp school) I agree to the processing by the organizers of the competition my child's personal information and placement of the image on the school website under the Law on Personal Data Protection dated. 29.08.1997. (Dz. U. No 133, item. 833, as amended. Amended) ........................................................................ .. The signature of parents or legal guardian………………………………………….. „My musical inspirations.” The sixteenth edition of the International Competition APPLICATION FORM Instrumental category - solo 1. Name and surname of………………………………………………………………………………………………………………….. .............................................................................................................................................................. 2. Class, instrument and cycle…………………………………………………………………………………………………………... 3. Name and address of school............................................................................................................ ............................................................................................................................................................... 4. Name and surname of teacher , number of telephone, e-mail........................................................ ……………………………………………………………………………………………………………………………………………………………. 5. Program ……....................................................................................................................................... .................................................................................................................................................................. .................................................................................................................................................................. ................................................................................................................................................................... 6. Expected duration of the program ...................................................................................................... 7. Name and surname of accompanist.................................................................................................... 8. Booking dinners, accommodation…./pcs.... ….... …............................................................................. Signature of teacher……………………………………………………………………………………………………………………………. Date and signature of a headmaster of school…………………………………………………………………………………… …………………………………….................................... ( stamp school) I agree to the processing by the organizers of the competition my child's personal information and placement of the image on the school website under the Law on Personal Data Protection dated. 29.08.1997. (Dz. U. No 133, item. 833, as amended. Amended) The signature of parents or legal guardian…………………………………………..