Instituia Public Naional a Audiovizualului

Cerere de nregistrare

la Concursul de Preselecie pentru reprezentarea Republicii Moldova la Concursul Internaional Eurovision

Song Contest 2018, Lisabona, Portugalia.

Bazai pe informaia primit (Anexa1), prin completarea prezentei Cereri, confirmm nregistrarea la
Concursul de Preselecie Eurovision Song Contest 2018 (Republica Moldova), suntem familiarizai cu
Regulamentul privind condiiile Concursului de Preselecie i suntem de acord cu stipulrile acestuia.

Titlul piesei: __________________________________________

Interpret (nume, semntur): _____________________________/____________

Compozitor (nume, semntur): _____________________________/____________

Autor text (nume, semntur): _____________________________/____________

Aranjament (nume, semntur): _____________________________/____________

Data depunerii cererii __________________________________________

Date biografice interpret: _________________________________________

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Date biografice, compozitor: _________________________________________

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Date biografice, autor text: _________________________________________

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Date biografice, aranjor: _________________________________________

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Telefon:__________________________________
Email:____________________________________

Contacte TRM:
MD2028, Chiinu, os. Hnceti 64
Tel.:/Fax: /+373/ 73 94 70
Email: eurovision@trm.md
www.trm.md