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Application form 11th Liszt Competition 2017

After you apply, an email will be sent to you to confirm your application. Unfortunately, we are experiencing some technical issues with our application form. If you do not receive a confirmation after 24 hours, please contact info@liszt.nl. Good luck with your application!

Personal information
First name*
Last name*
Date of birth (dd-mm-yyyy)* - -
Gender Male Female
Nationality*
Passport number*
Expiration date (mm-yyyy) -

Street address*
ZIP / Postal code*
City*
State / Province (if applicable)
Country*
Phone number (home)
Phone (mobile)*
E-mail*

Website http://
Facebook page http://www.facebook.com/
YouTube video http://www.youtube.com/user/
(Youtube video of a recording by participant of a work by Franz Liszt)


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