Entry form for the Artweb Award Festival All fields marked with (*) are required. Salutation* Please SelectMr.Mrs. Required field! Please choose your salutation! First name* Required field! Please enter your first name! Last name* Required field! Please enter your last name! Birth date Day01020304050607080910111213141516171819202122232425262728293031 / Month010203040506070809101112 / Year196019611962196319641965196619671968196919701971197219731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013 Entrada no válida Street & Nr.* Required field! Please enter your street and your house number! Zip code/City* Required field! Please enter your zip code and city! State Required field! Please enter your state! Country* Please SelectAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean territoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, Democratic RepublicCook IslandsCosta RicaCôte d'Ivoire (Ivory Coast)Croatia (Hrvatska)CubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea (north)Korea (south)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, Former Yugoslav Republic OfMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis and Futuna IslandsWestern SaharaYemenZaireZambiaZimbabwe Required field! Please select your country! Phone* Required field! Please enter your telephone or mobile phone number! Mobile phone Required field! Please enter, if available, your fax number! eMail* Required field! Please enter your email address! AAF Section* Please select01. Pictures02. Music03. Short film04. Book05. Photography06. Smartphone video07. PC graphic08. Music videoclip09. Real action video10. Poetry video11. Sculpture12. Performance13. Body art14. Accessoires design15. Fashion16. Invention17. Architectural design18. Film or theatre idea19. Dance performance20. Software idea21. Graffiti22. Street Art23. Discovery Required field! Please select your desired section! Upload* Required field! Please upload your artwork here! Message Optional: Describe your work of art ... Required field! Please describe or send us a message about your artwork! Terms of Participation* I have read and accepted the Terms of Participation (1 to 1.22, 2 to 2.3, 3. to 3.7 and 4 to 4.9) of the Artweb Award Festival (AAF). Required field! Please confirm that you have read and accepted the Terms of Participation (1 to 1.22, 2 to 2.3, 3. to 3.7 and 4 to 4.9) of the Artweb Award Festival (AAF). ------------------------------------------------------------------------------------------------------ Credit card I pay the start registration with my credit card Visa No. after receiving the invoice. Entrada no válida Credit card VisaMasterCardAmericanExpressDiners Club Entrada no válida Credit card Nr. Entrada no válida Credit card holder Required field! Please enter your last name! Date Start Month/Year Entrada no válida Date Expiration Month/Year Entrada no válida ------------------------------------------------------------------------------------------------------ Bank transfer I will pay the invoice amount after receiving it to the account of the charitable foundation of the museum "Fundacion Liedtke" at La Caixa in Port d'Andratx Account IBAN: ES 46 2100 1390 4602 0020 0403 BIC: CAIXESBB652 Entrada no válida Privacy policy Yes* I accept Entrada no válida Capcha* Actualizar Entrada no válida Send Reset
