SCHEDA DI ADESIONE Spedire riempita e firmata tramite e-mail all’indirizzo [email protected]

Presentazione Artisti Itineranti Invio la mia adesione alla “P.A.I. ART”:

Oppure inviare tramite Fax al numero 0575/ 815878 PITTURA – SCULTURA – ARTE FOTOGRAFICA Costo della quota di partecipazione (settimanale *)

Cognome e Nome ___________________________ Nome d’Arte ________________________________ Luogo e Data di nascita _______________________ Domicilio Città ______________________________________ Via e Cap __________________________________ Tel/Cellulare ________________________________

ƒ

Euro 100 + IVA/opera

Ogni artista può esporre più opere. *Nel caso di Esposizione per settimane successive la prima, verrà riconosciuto lo sconto del 10% sui seguenti costi settimanali. Il pagamento della quota di iscrizione settimanale potrà essere fatto entro la settimana antecedente l’inizio della mostra, tramite: ƒ

Codice fiscale _______________________________ E-mail _____________________________________

ƒ

Sito Internet ________________________________

ƒ

Opera 1 Titolo _____________________________________

Versamento sul c/c n. IT 32L0539071530000000001450 intestato a JWR Grandi Eventi Srl Assegno bancario intestato a JWR Grandi Eventi Srl Direttamente al Responsabile Walter Tiezzi o presso JWR Grandi Eventi Srl, via della stazione 54/A Monte San Savino (AR) 

Anno ______________________________________

Accetto: 

Tecnica e supporto ___________________________

1 – tutte le norme della Liberatoria allegata 

Misure ____________________________________

2  –  di  autorizzare  espressamente  JWR  Grandi  Eventi  Srl,  nonché  i  loro  diretti  delegati,  a  trattare  i  dati  personali  trasmessi ai sensi della legge 675/96 (legge sulla Privacy) e  successive modifiche. 

Prezzo ____________________________________ Opera 2 Titolo _____________________________________ Anno ______________________________________ Tecnica e supporto ___________________________

Data 

 

________ 

 

Firma di adesione 

 

___________________________ 

  Per ulteriori informazioni: 

Misure ____________________________________ Prezzo ____________________________________

Walter Tiezzi cell. 335 5210187 Tel. 0575 810742 oppure  [email protected]  

Opera 3

 

Titolo _____________________________________

 

Anno ______________________________________ Tecnica e supporto ___________________________ Misure ____________________________________ Prezzo ____________________________________

Sede generale e amministrativa JWR Grandi Eventi S.r.l. Via della Stazione, 54/A 52048 - Monte S. Savino (Arezzo) Tel. 0575/810742 Fax 0575/815878 E-mail: [email protected] 

Modulo Adesione P.A.I ART.pdf

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