On-Line Application Form

12th Warsaw Piano Workshop

August 10-20, 2011

Applicant Information
Name (first and family name) :
Address (street and number):
City:
   
State:*  Zip:* Country:
e-mail address :
Home Telephone Number:
   
Mobile Telephone Number:
   
Experience
Name of Present Teacher:
School:
Level Of Education:
Primary School
(under 13)
High School / College (13-18)
University (over 18) / Professional 
Focused Repertoire during Workshop:
Repertoire provided for Public Concert:
Tuition (USD):
Age 16 and Over 16

$1,000,00

Age Under 16

    $750,00
 
 
after receive acknowledgement of your enrollment from the WPW by e-mail -
 
PLEASE WIRE TUITION FEE BY THE END OF JUNE, 2011
TO THE FOLLOWING BANK ACCOUNT:
 
BANK:  ING BSK S.A. O/Warszawa - Odyńca
BANK'S SWIFT CODE:  INGBPLPW
ACCOUNT NAME:    impresariat ps.art. - Paweł Skrzypek
ACCOUNT NUMBER (IBAN): PL49105010411000002258434568
 
BANK'S POSTAL ADDRESS: 
ING Bank Śląski S.A.,  ul. Odyńca 69,  02-606 Warsaw,  Poland