Registration Form (Deadline: July 1, 2013)

Please Tick Appropriate Boxes

Please Print Out Form, Fill In Information
And Return With Registration Fee To:

Stockhausen Foundation For Music
Hachenberger Weg 57, 51515 Kürten, Germany
Tel: + 49 (0)2268-908757
Fax: + 49 (0)2268-908848
Stockhausen-Stiftung@t-online.de

Please enroll me, __ Mr. / __ Ms.:

Name:_________________ Surname:____________________

Date of birth:________________________________________

Street:_____________________________________________

City with Zip code:___________________________________

Country:____________________ Tel.:___________________

Fax:____________________ e-mail:____________________

as participant to Stockhausen Courses Kürten 2013.

Composer__ Musicologist:__ Sound Projectionist__Auditor:__

Interpreter__: Instrument:_____________________________

I have prepared the following work(s):

__________

___________

____________

Date:________________ Signature:____________________

Dates (arrival-departure)

August 2nd 2011–August 12th 2013________________

other:_____________________________ __

Arrival

I will have a car: yes:__ maybe:__

My car and me would be willing to participate
in a car pool while in Kürten: yes__, no:__

Preferred lodging:

private* (0-15 €)__

hotel single room* (ca. 30-65 €)__

hotel double room* (ca. 30-65 € per person)__

vacation apartment* (15-30 € per person)__

I do not need lodging:__

I agree to share a room with another participant __
I have enclosed a check of __ 340 €*, __ US$ 450*.
(*including 15 € US$ 20 bank handling charges).

__ I have transferred 325 € to the Stockhausen-Stiftung für Musik
(IBAN: DE 41 3701 0050  0121 6785 09; BIC / SWIFT: PBNKDEFFXXX).
Bank charges for the transfer are at my expense.
_ I have paid 325 Euro by PayPal