APPLICATION FORM

 

 

Send to:

"IL CIOCCO"
Centro Internazionale
56020 Castelvecchio Pascoli (Lucca)
I T A L Y

For the attention of: Mr. Cheloni
Telephone: 39 (0) 583 719 206
Fax: 39 (0) 583 719 240
Fax: 39 (0) 583 723 197
EMail: commerciale@ciocco.it

Name and surname

 

Address

Telephone

 

eMail

 

fax

Postal Code

  

Town or City

Country

LIST OF APPLICANTS

Name and surname

birth day
Sex
Activity1
Level2
Fl3
Sw3
Sb3

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Note:
1 FNC= fencer, STF= helper and staff, COI= Coach and Instructor
2 A= amateur, C= competing
3 Weapon used Fl=foil, Sw=sword, Sb=sabre

 Single room

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Total applicants

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Two-bed room

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Total sum

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Three-bed room

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Deposit (20%)

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TOTAL BALANCE (to be paid by 30/7/2000)

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 Means of payment

  • Credit card

 

  • Bank transfer

Credit card number ...

Expiration date

Transfer Pisa Airport / Railway Station to IFC

  • By bus at 03:00 p.m.
  • By bus at 07.00 p.m.

Note:

Date

I enable to compute my personal data conforming
to the Italian law number 675/1996
Signature