Transcript Brand Ceramics in Ascoli Piceno

Brand Ceramics in Ascoli Piceno
4rd Biennial International Competition
“Tra Tradizione e Modernità”
(Between Tradition and Modernity)
Entry form
Personal data (To complete legibly and in block letters)
Surname: ________________________________________________________________________
Name: ____________________________________________________________________________
Male o Female o
Date and place of birth: _____________________________________________________________
Nationality: _________________________________________________________________________
Address – Street and number:_________________________________________________________
Zip Code:_____________________________________________________________________________
City:__________________________________________________________________________________
Province/State/Country:________________________________________________________________
Telephone number (indicate country and city code):
___________________________________________________________________________________
Fax: ______________________________________________________________________________
E-Mail: ___________________________________________________________________________
Title of the work: __________________________________________________________________
Information regarding the work (to complete legibly and in block letters)
Tecnique-Material : _______________________________________________________________
Firing : __________________________________________________________________________
Size: _______________________________________________________________________
Diameter of the work: ___________________________________________________________
Decor: __________________________________________________________________________
Insurance value in Euro: _________________________________________________________
Specify if holder of a Cat. marking, and if so, indicate number:_________________
Date
________________________
Signature
_________________________
To submit by 15th february 2016, along with the material requested, as per art. 3 of the
competition rules.
Internet address:
www.comune.ascolipiceno.it
www.ceramics-online.it
www.ascolimusei.it
www.cultura.marche.it
www.facebook.com/ascolipiceno
www.twitter.com/comuneAp
Include 2 A5 photos on a homogenous background and biography.
Submit to:
Competition: “Tra Tradizione e Modernità”
Ceramiche di Marca ad Ascoli Piceno.
Museo dell’Arte Ceramica- Musei Civici
Piazza Arringo,7
63100 Ascoli Piceno
All information will be used in conformity with what is established by Legislative Decree - D.lgs.196/2003,
regarding privacy laws,
and only for the realization of the event.