• European competition "Guide to the european health resorts"

European competition
“Guide to the european health resorts”
Application form for the secondary schools
Please send the completed application form to: a.spinelli@fastwebnet.it
or to the fax n°. 0039 362 1792339
Within the 20 April 2009
Name Institute: ________________________________________________________________
City: ________________________________________________________________
Address: ________________________________________________________________
Post code: ________________________________________________________________
Phone: ________________________________________________________________
Fax: ________________________________________________________________
E-mail: _______________________________________________________________
Total school population of Institute: ______________________________________
The institute asks to join the Competition “Guide to the european health resorts”
with a number of teachers equal to: _______________________
with a number of classes equal to: _______________________
total number of students involved in the competition: _______________________
E.S.C.O.T. – EUROPE E.S.C.O.T. – EUROPE E.S.C.O.T. – EUROPE E.S.C.O.T. – EUROPE
Presidency Vice Presidency Vice Presidency Registered Office
Head Office Representation Ministry of Health Ministry of Health Via Vivaio, 12 – 10122 Milan
Calabria Region General Directorate of Health Dep. of Health’s System Organization General Direction
Place Campitelli, 3 AL. D. Alfonso Henriques, 45 Miodowa Str., 15 Via Vincenzo Monti, 1
00186 – Rome 1049 – 005 Lisboa 00 – 952 Warsaw 20048 Carate Brianza (Milan) ITALY
ITALY PORTUGAL POLAND Tel./fax + 39 (0) 362.1792339
 Please Send the completed application form to: a.spinelli@fastwebnet.it
or to the fax n°. 0039 362 1792339
Within the 20 April 2009
List of participant teachers:
Responsible teacher’s contact
Name and Surname: _______________________________________________________
Phone: _______________________________________________________
Portable phone: _______________________________________________________
E-mail: _______________________________________________________
Other teachers involved in the competition
Name and Surname: ____________________________________________________________
E-mail: ____________________________________________________________
Name and Surname: ____________________________________________________________
E-mail: ____________________________________________________________
Name and Surname: ____________________________________________________________
E-mail: ____________________________________________________________
Name and Surname: ____________________________________________________________
E-mail: ____________________________________________________________
Date, _______________________________
Stamp of the school The Headmaster
E.S.C.O.T. – EUROPE E.S.C.O.T. – EUROPE E.S.C.O.T. – EUROPE E.S.C.O.T. – EUROPE
Presidency Vice Presidency Vice Presidency Registered Office
Head Office Representation Ministry of Health Ministry of Health Via Vivaio, 12 – 10122 Milan
Calabria Region General Directorate of Health Dep. of Health’s System Organization General Direction
Place Campitelli, 3 AL. D. Alfonso Henriques, 45 Miodowa Str., 15 Via Vincenzo Monti, 1
00186 – Rome 1049 – 005 Lisboa 00 – 952 Warsaw 20048 Carate Brianza (Milan) ITALY
ITALY PORTUGAL POLAND Tel./fax + 39 (0) 362.1792339