resign academy form

Application Form Verona 24/8/09 – 11/9/09 Profile Name: …………………………………. Surname: …………………………….. Headline: ……………………………………………………………………… Education: …………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………… Contact Address: ……………………………………………….. E-mail: ………………………………….. Website: ………………………………… Tel.: …………………………………. Attached • One personal picture. • Curriculum Vitae. • Minimum n° 3 pictures of your works (advised, but not obligatory). Autorizzo al trattamento dei miei dati personali ai sensi del D. L. 30 giugno 2003 n. 196 e all’utilizzo del materiale da me fornito nell’ambito delle iniziative promosse da Resign e dalla associazione culturale Do – nucleo culturale di Faenza. Data.________________________ FIRMA:____________________________

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Resign Academy Form

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Application Form

Verona 24/8/09 – 11/9/09

Profile Name: …………………………………. Surname: …………………………….. Headline: ……………………………………………………………………… Education: …………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………………………… Contact Address: ……………………………………………….. E-mail: ………………………………….. Website: ………………………………… Tel.: …………………………………. Attached

• One personal picture. • Curriculum Vitae. • Minimum n° 3 pictures of your works (advised, but not obligatory).

Autorizzo al trattamento dei miei dati personali ai sensi del D. L. 30 giugno 2003 n. 196 e all’utilizzo del materiale da me fornito nell’ambito delle iniziative promosse da Resign e dalla associazione culturale Do – nucleo culturale di Faenza. Data.________________________ FIRMA:____________________________

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