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(to be annexed to the portfolio)
Name :
First name :
Age :
Tel. No.:
Professional
photographer
Student of
photography
Street address :
Postal code and town :
Country :
Project title :
Number of items submitted :
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Competing for :
Grand Prix de la
Ville de Vevey
Alpa Prize
Special Jury Prize -
Kodak Prize
Leica Small Format
Documentary Prize
Broncolor Lighting
Prize
Sinar Prize
Hasselblad Prize
Annexes :
Project
outline
Biography
Receipt of
payment of registration fee
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Payment of the EUR 25 registration fee :
by bank transfer
to Banque Cantonale Vaudoise, Lausanne,
Swift Code BCVLCH2L, in favour of Association Images,
CH-1800 Vevey,
account No. CO 902.94.74
by post office
transfer to Swiss post cheque account No 18-25767-0
Place - Date :
Signature :
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