Registration Form

43rd International EPTA Conference “Connecting Continents & Traditions” Registration Form
Nombre - Name:*

First NameLast Name
Passport number:*
E-mail address*

Confirmation Emailexample@example.com
Please, select one of the following options:*

EPTA President (free)**Participants / non-members (180€ /early booking 160€)EPTA Spain member (170€ / early booking 150€)Lecturer (160€ / early booking 140€).***Student (90€)
Will you join us for the Gala Concert and Dinner? Dress code (business, cocktail) required*

Yes (65€ / early booking 60€)No
**I am President of EPTA “Select country”
EPTA President Country
***If you have sent a proposal, please be aware that you will be notified by May 15th (early booking up to May 31st)
Payment Data

Make bank transfer first and add confirmation receipt
Payment in full must be made through bank transfer to the following bank account data:

Account Holder: ASOC EUROPEA DE PROFESORES DE PIANO EPTA
Bank: BANKINTER
IBAN : ES74 0128 0018 5101 0003 8586
BIC / SWIFT : BKBKESMMXXX
Address: C/ López de Hoyos 116-118. 28002 Madrid (Spain)

Please, keep your bank transfer receipt for your records. You will need to add it in order to fill out and send your registration form.
Billing Address
Street Address*
City*
State / Province*
Zip / Postal Code*
Country*
Is your mailing address the same as your billing address?*

YesNo
Mailing address
Street Address*
City*
State / Province*
Zip / Postal Code*
Country*
Phone number*
What best describes you?

Independent teacherCollegiate facultyCommunity music school facultyStudentNew professional
Add Bank Receipt *

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43rd International EPTA Conference “Connecting Continents & Traditions” Registration Form

Payment Data

Billing Address

Mailing address