Ficha de inscrição individual - III ENARTECAP - 12 a 14/07/2013
Autor: Débora Ferreira Comonian | Publicado: 2013-03-18T10:25:00-07:00





FICHA DE INSCRIÇÃO
INDIVIDUAL - 12 a 14/07/2013 


&nbsp;


1-&nbsp;&nbsp;&nbsp;&nbsp;
DADOS PESSOAIS:


&nbsp;


Nº ________ (Campo a ser preenchido pela Comissão
Organizadora)


Nome: _________________________________________ Crachá:
____________________


Data nasc.: &nbsp;___/___/___
&nbsp;Sexo: ___ &nbsp;Estado civil: ___________ &nbsp;Profissão: ______________


Endereço residencial:
________________________________________________________


Bairro: _____________________ Cidade: _______________________
&nbsp;Estado: __________


E-mail: _________________________________________


Telefones: ______________________________________


&nbsp;


Instituição Espírita que frequenta:
_______________________________________________


Cidade: _____________________ Estado: ____________


Tel.: (____)_________________ E-mail da Instituição:
_______________________________


&nbsp;


&nbsp;


2-&nbsp;&nbsp;&nbsp;&nbsp;
DADOS&nbsp;
DE SUA PARTICIPAÇÃO:


&nbsp;


Gostaria de
participar de qual oficina?


( &nbsp;) Música&nbsp;&nbsp;&nbsp;
&nbsp;( &nbsp;) Canto/Coral&nbsp;
&nbsp;( &nbsp;) Artes Plásticas&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp; )
Literatura&nbsp; &nbsp;&nbsp;(&nbsp; )
Teatro &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;( &nbsp;)
Dança


&nbsp;


Dia e horário que
pretende chegar:


( &nbsp;) 12/07/2013 - ____:____ horas&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ou&nbsp;
(&nbsp; ) 13/07/2013 - ____:____ horas


&nbsp;


Meio de locomoção:
( &nbsp;) particular&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp; )
condução fretada&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;
) ônibus de linha


&nbsp;


Pretende
participar:


(&nbsp; ) de 12 a 14/07/2013&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ( &nbsp;&nbsp;) de 13 a 14/07/2013 ou&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp; ) somente um
dia/qual? ______


&nbsp;


Pretende utilizar a
hospedagem oferecida pela Equipe Organizadora? (&nbsp; ) sim&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;
) não


(Valor de cada
diária R$ 20,00 – vinte reais)&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 
(&nbsp;&nbsp;&nbsp; ) 2 noites&nbsp; ou&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp; ) 1 noite


&nbsp;


Quer adquirir
antecipadamente o ingresso para o Espetáculo Musical? (&nbsp; ) sim &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;( &nbsp;) não


(Ingresso R$ 15,00
- quinze reais) 


&nbsp;


Quer adquirir a
camiseta do evento? (&nbsp;&nbsp;&nbsp; )sim&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;(&nbsp;&nbsp;&nbsp;
)não (Valor = R$ 20,00 – vinte reais)


Tamanhos&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp;
)P&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp; )M&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp; )G&nbsp;
(tradicional)


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp; )P&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp;
)M&nbsp;&nbsp; (&nbsp;&nbsp;&nbsp; )G&nbsp;
(baby look)


&nbsp;


Sua participação:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp;
) Inscrição (30,00)


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ( &nbsp;&nbsp;) 2 diárias (40,00) ou ( &nbsp;&nbsp;) 1 diária (20,00)


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp; ) Espetáculo Musical (15,00) (opcional)


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp; ) camiseta (20,00) (opcional)&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Total: R$____________


&nbsp;


Quer pagar em
quantas parcelas? (&nbsp;&nbsp; ) Uma&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (&nbsp;&nbsp; ) Duas


&nbsp;


Data limite para
inscrição e pagamento total: 10 de junho de 2013


&nbsp;


Pagamentos
realizados em:&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; ____/____/____ e
____/____/____&nbsp; (pela Organização)


&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 


Favor enviar ficha
de inscrição e comprovantes de pagamento escaneados para o e-mail: enartecap@hotmail.com, pois a inscrição somente será efetivada após a comprovação do
pagamento.


Obs.: Em caso de desistência não haverá
devolução da inscrição realizada.