TO THE BOARD OF DIRECTORS OF THE CULTURAL ASSOCIATION

EURASIA DANCE PROJECT INTERNATIONAL NETWORK

President of the Association: Stefano Fardelli

2020 MEMBERSHIP FORM N°

Membership: registration form for the association for the year 2020.
This document is valid for the entire calendar year, expiring on the 31st December 2020.

The undersigned

Name: Sachini Surname: D.G.Sachini

Sex:Female

Place of birth: Colombo (SriLanka) City: Colombo

Country: SriLanka
Date of birth: 28 / 06 / 1997 Address: "Maheshi Printers" , Kaluaggala, Hanwella,
Colombo, SriLanka
Post Code:
City: Colombo Country: SriLanka
976800222V
Identity Card number: Passport number:N6985803

Age: 23 Nationality: SriLankan

Phone number: +94755795217 Mobile Number: +94779182196 Fax:

E-mail:
fiya795217@gmail.com
REQUESTS

to join the Cultural Association "EurAsia Dance Project International Network" for the year 2020 as a
MEMBER.
To this end he declares to have read the Statute, to approve it in its entirety and to share the principles and
aims of the Association.
The membership has no cost and therefore by filling in this document no payment is required.

To this end he declares: To exempt the EurAsia Dance Project International Network Association
from any responsibility for all damages, physical and / or patrimonial, which may derive from the undersigned
from the performance of the activities organized by the association if they are not a direct consequence of the
fraud or gross negligence of the Association itself.

Signature Date 17 /11 /2020

DISCLOSURE PURSUANT TO ART. n. 196 of June 30, 2003 and s.m.i. The acquired personal data will be used, also
with the aid of electronic and / or automated means, exclusively for the performance and management of the activities
related to the purposes of the association. Pursuant to Legislative Decree n. 196 of June 30, 2003 and subsequent
amendments, has the right to access their data, requesting correction, integration and, in extreme cases, cancellation or
blocking.
Having taken note of the aforementioned information, I authorize the processing and communication of my data within
the limits of the same.
Authorize
Signatur .........................................................................