Summer Camp Application Form 2016/2017. ABADIR Academy ... IBAN: âIT 02 C 05036 84230 CC0401263092 â SWIFT: âPOPRI
RELATIONAL DESIGN Summer Camp Application Form 2016/2017
ABADIR Academy Via Giacomo Leopardi 8 S. Agata Li Battiati 95030 Catania, Italy
The Undersigned _____________________________________ Date of Birth _____________________ Country of Birth ___________________________ Nationality __________________________________ Passport Number ___________________________ Passport Issue Date _________________________ Passport Expiry Date ___________________ Country of Ordinary Residence ______________________ Home Address _______________________________________________________________________ Phone ___________________________ E-mail _____________________________________________
HEREBY REQUESTS to apply for the Summer Camp ‘Service Design South’ of the Master Relational Design
For this purpose, the Undersigned declares on his/her responsibility:
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To pay the subscription fee of €350,00 v ia bank transfer. Bank account details: Account name: R.AR.A. SRL (Ente Gestore Accademia Abadir) IBAN: IT 02 C 05036 84230 CC0401263092 SWIFT: POPRIT31040 BANK: Banca Agricola Popolare di Ragusa
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To enclose a copy of the passport or other ID (Identity Document)
Date
Signature
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Information regarding the processing of personal data (D.L. n. 196 ofl 30/06/2003): Candidates’ personal data will be kept and used only for didactic and administrative purpose, with the utmost respect to the right to privacy.
