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Prénom du stagiaire *

Nom du stagiaire *

Adresse *

C.P. *

Commune - Ville - Village *

Pays *
—Veuillez choisir une option—BelgiqueFranceSuisseAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiqueBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral AfricanChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCôte d\IvoireCroatiaCubaCyprusCzech RepublicDemocratic People\s Republic of KoreaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFederated States of MicronesiaFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIraqIrelandIslamic Republic of IranIsle of ManIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOccupied Palestinian TerritoryOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of KoreaRepublic of MoldovaRepublic of the CongoRéunionRomaniaRussian ederationRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint-Pierre and MiquelonSamoaSan MarinoSao Tome and rincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth eorgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSuisseSyrian Arab RepublicTaiwanTajikistanThailandThe Democratic Republic Of The CongoThe Former Yugoslav Republic of MacedoniaTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S.Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited Republic Of anzaniaUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican City StateVenezuelaVietnamWallis and FutunaWestern aharaYemenZambiaZimbabwe

Date de naissance *, ^{minimum 7 ans dans l'année du stage}

Sexe *
MFX

Choix de l'instrument principal

1er instrument * (460,00€)
—Veuillez choisir une option—PianoViolonVioloncelle

année(s) de pratique *

2ème instrument (130,00€)
—Veuillez choisir une option—Sans objetViolonVioloncelle

2ème instrument (130,00€)
—Veuillez choisir une option—Sans objetPianoVioloncelle

2ème instrument (130,00€)
—Veuillez choisir une option—Sans objetPianoViolon