Personal data
Salutation:
Salutation ...
Mrs. / Ms.
Mr
First Name:
Name:
Street, Street Number:
Postcode, City:
Country:
Telephone:
Mobile Phone:
E-Mail:
As student
Name of school:
Place:
Semester:
As a group of students
Name of school:
Place:
Name of project group:
Please note: when register as a group of students for the contest, one member of the group has to register above with his/her personal details.
As entrant
Occupational Certificate:
Year of Certificate:
Regarding the Design
Subject:
Year of Draft:
Brief Description of the Design:
I/we hereby confirm that I/we have designed and realized the submitted piece without any outside assistance and that it is indemnified from any third party claims. I/we also declare my/our express agreement to the terms of participation of the call for entries (see also
www.beckerContest.com
).
