Coordinates

Last name   *

First name   *

Gender   ---- Male Female *

Date of birth   * (YYYY-MM-DD)

Place of birth   *

Nationality   *

Address   *

Tel. number  

Mobile phone number  

E-mail   *

Studies

Studying at   *

Current teacher  

Current level  

Graduated at  

Name teacher  

Kind of diploma  

Graduated date   (YYYY-MM-DD)

I accept the competition regulations (see www.gitaarconcours.be)

Registration fee

Contact: contest secretary: Ginstdreef 34, B-9820 Merelbeke, or email:ingevdk@skynet.be