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ENTRY FORM (to accompany your score in a sealed envelope)

Name of composer:  
Age:  
Male/Female:  
Nationality:  
Postal address:  
Tel. (incl. dialling codes):  
Email:  
   
Title of work:  
(Titles of movements):  
Instruments:  
Total duration:  
(Duration of movements):  
Further details of work:  
   
   
   
Signature: