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    Solo entry form    

 

 

PRETORIA EISTEDDFOD

ENTRY FORM (A):    SOLOS/INDIVIDUAL


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 


Section

Code

  E     ESE     A     AS     ASA     R     P     W     G     KJ     KS     L     LM     VJ     VS     S  

 

 

PART A:  DETAILS OF AFFILIATED TEACHER/CONTACT PERSON

 

Name and Surname:_____________________________________________________________________________________________________________________________

 

Telephone numbers (both):___________________________________________ (h) ____________________________________________________________________ (cell)  

         

Postal address:_____________________________________________________________________________________________________________________________________

 

PART B:  DETAILS OF TEACHER (Compulsory)

 

Name and Surname:____________________________________________________________________________________________________________________________

 

Telephone numbers (both):___________________________________________ (h) _____________________________________________________________ _____(cell)      

     

Postal address:_______________________________________________________________________________________________________________________________

 

PART C:  DETAILS OF CANDIDATE

 

Name and Surname (as for certificate):______________________________________________________________________________________________________________

 

Telephone numbers (both):___________________________________________(h) ___________________________________________________________________(cell)

 

School: ___________________________________________________________________________________________________________________________________

 

Grade: _______________________________________________________Age on 01-01-17: _________________________________________________ Afrikaans/English

 

PART D:  DETAILS OF ITEM/S (One form per SECTION per CANDIDATE. Duo’s trio’s etc. on separate form!)              

 

Code

Item no.

Description item

Instrument: period

Vocal: voice

Duration

Min.      Sec.

Amount

1.

 

 

 

 

 

2.

 

 

 

 

 

3.

 

 

 

 

 

4.

 

 

 

 

 

5.

 

 

 

 

 

6.

 

 

 

 

 

7.

 

 

 

 

 

 

 

 

 

TOTAL

R

Postal address:  

 

Pretoria Eisteddfod

 

P.O. Box 41890

 

MORELETA PARK 0044

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

 

Fax no. 08663 277 28

Banking Details:

Bank:                   Standard Bank, Menlyn

Account name:      SAVMO Pretoria Eisteddfod

Account number:   012 186 104

Branch code:         012345

 
 
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