Partecipation Form For The International Summer School
I request to partecipate in the international summerschool that will take place in Bolzano. Board expenses are payed by the Foundation, payable true the bank or cash on the beginning of the summerschool.
Name and surrname_____________________________________________________
Address ________________________________________________________________
City/Cap__________________________________Country_______________________.
tel/fax__________________________________E-mail__________________________
Date of birth _______________________________________.sex__________________
Studies, degrees___________________________________________________________
Activities ______________________________________________________________
Partecipation on behalf of an Association/ Institution (other) _______________________
Known languages _______________________________________________________
Date__________________________ Signature______________________
FONDAZIONE ALEXANDER LANGER STIFTUNG – Onlus
Fondata/Gegründet: 04.07.1999 – Riconosciuta/Anerkannt: 18.11.1999
Via Latemar Strasse 3, I - 39100 BOLZANO/BOZEN
Tel.+Fax. 0039 0471 977691 - E-Mail: langer.foundation@tin.it, www.alexanderlanger.org
Banca/Bank: Cassa di Risparmio di Bolzano - Südtiroler Sparkasse, Conto/Konto Nr. 555000 (Abi 6045 - Cab 11613)
Name and surrname_____________________________________________________
Address ________________________________________________________________
City/Cap__________________________________Country_______________________.
tel/fax__________________________________E-mail__________________________
Date of birth _______________________________________.sex__________________
Studies, degrees___________________________________________________________
Activities ______________________________________________________________
Partecipation on behalf of an Association/ Institution (other) _______________________
Known languages _______________________________________________________
Date__________________________ Signature______________________
FONDAZIONE ALEXANDER LANGER STIFTUNG – Onlus
Fondata/Gegründet: 04.07.1999 – Riconosciuta/Anerkannt: 18.11.1999
Via Latemar Strasse 3, I - 39100 BOLZANO/BOZEN
Tel.+Fax. 0039 0471 977691 - E-Mail: langer.foundation@tin.it, www.alexanderlanger.org
Banca/Bank: Cassa di Risparmio di Bolzano - Südtiroler Sparkasse, Conto/Konto Nr. 555000 (Abi 6045 - Cab 11613)