O F F I C I A L F O R M
1er ENCUENTRO INTERNACIONAL MINITEXTIL CONTEMPORÁNEO
MUSEO NACIONAL DE BELLAS ARTES
SANTIAGO CHILE
AGOSTO- SEPT- 2003
DATOS PERSONALES/ PERSONAL INFORMATION
NOMBRE / NAME :
............................................................................................................................ACTIVIDAD O PROFESIÓN/ ACTIVITY OR PROFESSION :..............................................................
DIRECCIÓN / ADDRES:
......................................................................................................................PAIS / COUNTRY : ..............................................................................................................................
CODIGO POSTAL / ZIP CODE : .........................................................................................................
TELEFONO / TELEPHONE:.................................................................................................................
FAX :
.....................................................................................................................................................CORREO ELECTRÓNICO / E-MAIL :.................................................................................................
DATOS DE LA OBRA / WORK INFORMATION
TITULO/ NAME :
................................................................................................................................CATEGORÍA / CATEGORY:
...............................................................................................................(BIDIMENSIONAL- TRIDIMENSIONAL- SERIES )
MATERIALIDAD/ MATERIALS :
.........................................................................................................TÉCNICA (S) /TECNIC ASPECTS :.....................................................................................................
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MEDIDAS / MEASURES :
ALTO/ HEIGHT:.....................ANCHO/ WIDTH:...................PROFUNDIDAD/ DEPTH:.....................
PESO/ WEIGHT( APROX) :
........................................................................................................... .ACOTACIONES/ NOTES : ...............................................................................................................................................................