Please, use a hard copy of this form for application.
An das
Akademie- & Konzertbüro Klaus Richter Fax: (+49) - 30 - 26 55 47 70 e - mail: klaus@richter-berlin.de
13th International Masterclass Kröchlendorff Castle 2007January 15th - January 20th 2007Application Form[]Violin []CelloProfessor: ______________________ Surname: ______________________ First name ______________________ Date of birth: ____________ Nationality: ______________________ Please, mark the matching word: [] male [] female Address: Street: ____________________________________________________________ Postal code: ____________ City: ________________________________ Telephone: ________________________ Fax: _______________________
Teachers(s): _______________________________________________________ City: ______________________________________________________________
Application as: [] active participant [] listener
Prepared pieces: ___________________________________________________ ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Arrival date: ____________ [] by car [] whithout a car Other: _____________________________________________________________
I will transfer the Registration fee (EUR 80,--) by
Klaus Richter account number: 1824002439 at the
Date: ____________ Signature: ___________________________
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