Application

48th Zenon Brzewski International Music Courses in Łańcut
– application form

    Family name:


    First Name:


    Date of birth (DD.MM.RRRR):


    Sex:
    MaleFemale

    Address:

    Address:


    Country:


    State / Province / Region:


    City / Town:


    Zip / Postal Code:

    e-mail:


    Phone number:

    I want to take part in course lessons during:
    Session One 1-13 July 2022 (Fee – 490 euros)Session Two 15-27 July 2022 (Fee – 490 euros)Session One and Two 1-27 July 2022 (Fee – 1900 euros)

    My choice of accommodation:
    SEZAM Hotel with full board (+ 500 euros for one session)room in a Łańcut resident’s without board (payment to the landlord – about 50 zlotys per night)I will make my own room and meals arrangements

    I come as:

    Instrument:

    I wish to study with prof.:

    Music training so far (say how long you have studied and where):

    Specify two or three pieces you want to study with your course tutor:

    I also wish to do (included in the course fee):
    aural trainingchamber musicstring orchestra

    Surname and name of the parent or legal guardian (when an applicant is underage):

    Phone number:

    Please note that course members and their guardians should arrange their own health and accident insurance.