Heves megyei aprónyomtatványok 14/C

To be filled in with typed or block letters! *

Application card

Name: .............................. family name

.

•••••••••••••••••••••••••••••. surname, /male-female/

Profession: ...........................

A

ddress: ..............country

........................ town

• 8treet and number

I announce that I would like to take part in the cinematic section of Eger Summer Course.

I note that the course fee is 5.000.- frt.

I shall transfer the course fee to the account of the County Organ of TIT No. 350-90171-9092. or I shall pay it on the premises, x

Please ensure RUSSIAN, GERMAN, ENGLITSH or FRENCH interpretation. x

Each applicant is kindly asked to fill in a separte card. Deadline of application:ist. May 1984.

x Please underline the proper part.

signature