G.A.St.Art. (Historical Group & Artistic Studio) “Monte San Savino Show 2011” - ITALY DISPLAY NR:_________ [ ] Juniores (no pay) [ ] Not in competition 1. FIGURE-Figurini CHOISE ONLY ONE CATEGORY (Scegli solo una categoria per modulo) Only 1 Display or Category for module 1.SP [ ] STANDARD PAINTING 1.MP [ ] MASTER PAINTING 1.SO [ ] STANDARD OPEN 1.MO [ ] MASTER OPEN _________________________________________________________________________________________ First Name/ Nome:_____________________________Surname/Cognome: ____________________________ Andress/Indirizzo :__________________________________________________________________________ City/Città:______________________Country/Paese:_________ E-MAIL:_____________________________ CLUB : __________________________________________________________________________________ NR. Ord TITLE –TITOLO Nr. Iscrizion 1 2 3 4 5 6 7 8 9 10 L’organizzazione non è responsabile dei furti e/o danneggiamenti.The organization is not responsible for any theft or damages.- Signature/Firma ________________________________________