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PRETORIA EISTEDDFOD

INSKRYWINGSVORM(B):  ENSEMBLES/SAMESPRAKE/DUO –, TRIOVOORDRAGPROGRAMME

ENTRY FORM (B):    ENSEMBLES/DUO- & TRIOLOGUE, ALL OTHER DUO/TRIO ITEMS

 

NB! ALL ENTRIES MUST BE PAID BY 30 MARCH 2017. UNPAID ENTRIES BY THIS DATE WILL NOT BE PROCESSED FOR PARTICIPATION IN THE 2017 EISTEDDFOD.


 

Afdelingskode

Section code:

A

AS

E

R

P

OR

G

KJ

KS

L

LM

VJ

VS

S

 

DEEL A:  BESONDERHEDE VAN GEAFFILIEERDE/AFRIGTER/KONTAKPERSOON

PART A:  DETAILS OF AFFILIATED TEACHER/CONTACT PERSON

 

Naam en Van: _______________________________________________________________________________________________________________________Afr./Eng.

Name and Surname:

 

Telefoonnommers(beide):__________________________________________(h) _________________________________________________________________(sel/cell)

Telephone numbers (both):

               

Posadres:___________________________________________________________________________________________________________________________________

Postal address:

 

DEEL B:  BESONDERHEDE VAN DEELNEMERS (Naam en van soos op sertifikaat)

PART B:  DETAILS OF CANDIDATES (Name and surname as for certificate)

 

1.    Naam en Van: ________________________________________________________________________________________________________________Afr./Eng.

Name and Surname:

 

                Skool: ___________________________________________Graad: _________________________________Ouderdom op 01/01/17:______________________

                School:                                                                                     Grade:                                                                    Age as on 01/01/17:

 

2.     Naam en Van: _______________________________________________________________________________________________________________Afr./Eng.

Name and Surname:

 

                Skool: ___________________________________________Graad: __________________________________Ouderdom op 01/01/17: _____________________

                School:                                                                                      Grade:                                                                    Age as on 01/01/17:

 

3.    Naam en Van:________________________________________________________________________________________________________________Afr./Eng

        Name and Surname:

 

                Skool: ____________________________________________Graad: _________________________________Ouderdom op 01/01/17: _____________________

                School:                                                                                       Grade:                                                                   Age as on 01/01/17:

 

4.    Naam en Van: _______________________________________________________________________________________________________________Afr./Eng.

Name and Surname:

 

                Skool: _____________________________ ______________Graad: __________________________________Ouderdom op 01/01/17: ____________________

                School:                                                                                      Grade:                                                                     Age as on 01/01/17:

 

5.    Naam en Van:________________________________________________________________________________________________________________Afr./Eng.

Name and Surname:

 

                Skool: ___________________________________________  Graad: __________________________________Ouderdom op 01/01/17: ____________________

                School:                                                                                       Grade:                                                                      Age as on 01/01/17:

 

 

DEEL C:  BESONDERHEDE VAN ITEM/S       

PART C:  DETAILS OF ITEM/S

 

 

Kode/Code

Itemnr./Item no.

Beskrywing van item/Description of item

Instrument: tydperk/period     

Vokaal: stemtipe/voice

Tydsduur/Duration

Min.      Sek./Sec.

Bedrag/Amount

1.

 

 

 

 

 

2.

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

TOTAAL/TOTAL

R

 

 

Posadres/Postal address:   Pretoria Eisteddfod

                                                Posbus 41890 P.O.Box

                                                MORELETAPARK 0044

E-posadres/E-mail address: kantoor@pretoriaeisteddfod.co.za

Faksnr/Fax no. 08663 277 28

 

 

 

 

 

 

 

 

 

 

 
 
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