Applicationform for Academycourse at BIBA-2012
Name:_____________________________ Personalnumber:_________________________
Address:_____________________________________________________________________
Phone:___________________________ E-mail:___________________________________
Male:_____ Female:_____
Instrument:___________________________________________________________________
Do you want us to book you at hotel Conrad/Aston in a doubleroom?
Monday-Sunday 1950 Sek inkl. breakfast, extra night cost 325 Sek inkl. breakfast.
Yes:_____ No:_____ Doubleroom:_____ Singleroom:_____
(We can´t guarante singleroom if you applay for it, if you get a singleroom that will cost you 225 Sek/night extra.)
Which Academy are you studying at/have been a student at?
_____________________________ Which grade/wich years did you study?___________
Have you been to BIBA before?_____ If yes, wich year/years?_____________________
Applicationform, together with DOCUMENTATION FROM YOUR MUSIC ACADEMY AND
A COPY OF YOUR PASSPORT
should be sent to:
Marcus Petersson
Sandfjärdsgatan 10
120 57 Årsta
Sweden
tel. +46-(0)705-527485
marcus.petersson@bredband.net
The applicationfee of 500 Sek should be payed before the 10th of June 2012 to:
Region Blekinge
Musik i Blekinge
Ronnebygatan 2
371 32 Karlskrona
Bankaccount: 5106-8914
IBAN konto: SE 75 8000 0816 9513 7676 4427
Swedbank
S-371 25 Karlskrona
Swift/BIC kod: SWEDSESS
Be sure to write BIBA 2012 on the payment.
Receipt should be shown at the coursestart. Application is binding. If you cancel after 10th
of June without valid reason you have to pay full coursefee (3.500 Sek).
I have read the conditions for the application and I accept these.
Town:________________________ Date:______________
Signature:__________________________________________