Author: Marilisa Rizzo
Company: EDS: UAF

Attachment A
(application form – classical section )			To:    Headmaster 
Bernardino Santoboni
Liceo Classico Statale
“Marco Terenzio Varrone”
Rieti

5th CERTAMEN VARRONIANUM REATINUM
RIETI 19-21 APRIL 2007

First name…………………………………………………………Family name…...............................................
Place of birth............................................City..............................Country.......................
Date of birth........................................................ School year.........................................

First name…………………………………………………………Family name…...............................................
Place of birth............................................City..............................Country.......................
Date of birth........................................................ School year.........................................

School Name
...................................................................................................................................

School address...............................................................................................................
Code..........................................City.............................................................................
Phone number.........................................................Fax:.................................................
E-mail...........................................................................................................................
Teacher ………………………………………………………..  Subject ………………………………………………………………….

Applies to

The 5th CERTAMEN VARRONIANUM REATINUM, in Rieti from April 19 to April 21, 2007 .
Tick the chosen section:

•	Classical Section
•	Historical-literary section
•	Technical and practical section

Student signature
....................................................
Date…………………………………..
Headmaster signature
........................................................