REGISRATION to PRIX VOLININE 1999
Print and send this page to CHOREA DIFFUSION - 25, rue Ampère   F-78100 St Germain en Laye FRANCE

--PLEASE WRITE WITH CAPITAL LETTERS--
IF UNREADABLE, YOUR REGISTRATION WILL BE REFUSED !



Name:........................................................... First Name:..................................

Birthday: ........./........./19....... Nationality:....................................................

Adress........................................................................................................................

...............................................................................................................................

Zip Code:............... City................................................. Country:.................................

Full phone number: ..................................................................

Fax:................................................ e-mail:....................................................

Ballet
Title:..........................................................................................

Number of dancers:.........number of musicians:..........Exact duration of ballet:.......mm......sec

Music by:........................................................................................................

Costumes by:...................................................................................................

Description of ballet (5 lines maximum) and resumé of choreographer: (enclose on separate sheets)

name of dancers: (to enclose on separate sheet.)

name of musicians: (to enclose on separate sheet.)

Enclosed is, an international money order for the sum of 480 French Francs made out to CHOREA Diffusion for PRIX VOLININE 1999 registration fees.

Very IMPORTANT Make your choise for elimination round:

ST-GERMAIN-EN-LAYE / PEYRESTORTES / VANVES /

The choreographer M.................................declares that he is familiar with the rules of the PRIX VOLININE and promises to comply with them fully and in every detail.

(city):...............................date: ...../...../..... (Signature)