Application Form

Workshop*

please chooseHeidelberg April 26-28th 2013Heidelberg May 10-12th 2013Heidelberg June 21-23th 2013Heidelberg June 28-30th 2013

Instrument*

 Cello    Piano  

Participant First/Last Name*

Companion Name

Street, Number*

Postcode, City*

Country*

Phone*

Mobile Phone

E-MAIL*

E-MAIL Confirmation*

Occupation

Birthday

Emergency Contact

Emergency Contact please enter here.

Arrival*

 Train     Car     Aeroplane     Still Open   

Lift

please chooseOffering One SeatOffering Two SeatsOffering Three SeatsRequesting One SeatRequesting Two SeatsRequesting Three Seats

Single Room

I wish the accommodation in a single room.

 No    Yes  

Remarks to the Accommodation

Remarks to the Accommodation please enter here.

Works*

I would like to play the following works.

Works please enter here.

Remarks / Messages

Remarks / Messages please enter here.

I came across the CPW like this:

e.g. Twitter, Facebook, XING, flyer, Google etc.

Data Privacy

Please check what should not appear
in the internal participant list.

  No Name    No Address    No Phone Number  
  No E-Mail-Address  

Acceptance of the Terms and Conditions*

I have understood and accepted the Terms and Conditions !

  Yes   

Confirmation of Participation*

The final participation confirmation will be sent only
after the entrance of a deposit payment of 50% of the course fee.
Please read all further information in our acknowledgement of receipt.

  I agree  

ReCubeForm