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  • Biblioteca - Ficha de Inscripción VIII Convocatoria Literaria PDF

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    221 views1 page

    Biblioteca - Ficha de Inscripción VIII Convocatoria Literaria PDF

    Uploaded by

    Anonymous hVueFN

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    FICHA DE INSCRIPCIN

    Nombre Completo: ________________________________________________________________________________________________________________


    Seudnimo: ________________________________________________________________________________________________________________________
    Telfono: ___________________________________________________________________________________________________________________________
    Correo Electrnico: _______________________________________________________________________________________________________________
    Direccin: __________________________________________________________________________________________________________________________
    Estudiante Docente Funcionario Otro: _______________________________________________________
    Facultad o Dependencia: ________________________________________________________________________________________________________
    Programa Acadmico: ___________________________________________________________________________________________________________
    Profesin u Ocupacon: _________________________________________________________________________________________________________
    Gnero con el que participa: Cuento Ensayo Poesa
    Ttulo del Texto 1: ________________________________________________________________________________________________________________
    Ttulo del Texto 2: ________________________________________________________________________________________________________________
    Ttulo del Texto 3: _______________________________________________________________________________________________________________
    Ttulo del Texto 4: ________________________________________________________________________________________________________________
    Ttulo del Texto 5: ________________________________________________________________________________________________________________
    Por la presente Si No autorizo la publicacin impresa o digital de los textos enviadas al concurso.
    Los autores conservan sus derechos de autor.
    Firma: _________________________________________________________

    Biblioteca Centro Cultural Jairo Panesso Tascn


    Tel. 665 2828 Ext. 1201 -1202 Av.6N #28N-102
    biblioteca@admon.uniajc.edu.co

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