BACK HOMEPAGE ARCHITECTURE PAINTING FOUNDATION

X.3.3.6

Application Form

STUDENT DATA

 
Name: 
Family name: 
First name: 
Male Female

Date and place of birth
Month:     Day:        Year:      
City:    State or Country: 
Country of citizenship:   

Address to which acceptance should be mailed
Street:
City:          State or country:
Telephone:   Fax:
E-mail: 

Permanent (home country) address: 
Housing:
I ask you to book for me an hotel
(send 200 $ deposit to reserve a room)
I will find my own housing
Method of payment:
by credit transfer to the Bank
CREDITO ARTIGIANO, Agenzia 9
Cab.01612 Abi 3512, c/c n°44/3601.0
by cheque ( to be sent with registered letter)
  by Credit Card
 
 
Visa
 
 
Carta Sì
 
 
EuroCard
 
Master Card
Card number: 
Expiration date:

How to apply:

  • complete and sign the application form
  • Send your payment
  • Send the complete application form to:

    The Vittorio Mazzucconi Foundation
    Course on Architecture and Urban Design 'The Citadel of Culture'

    1, Via Andrea Ponti, 20143 Milan Italy,
    by air mail
    by E-mail to arcadelduomo@gmail.com
    by Fax: +39 02 89125825