KANDIDATUUR CULTUURPRIJS 2014
In te dienen uiterlijk 31 december 2014 bij de Cultuurdienst, Nieuwstraat 21, 9570 Lierde of via mail aan cultuur@lierde.be Gegevens van de indiener Naam: …………………………………………………………………………………………………………………………………………………. Adres: …………………………………………………………………………………………………………………………………………………. Postnummer en plaats: ………………………………………………………………………………………………………………………. E-mailadres: ………………………………………………………………………………………………………………………………………… Telefoonnummer/gsm nr.: ………………………………………………………………………………………………………………….. Gegevens van de vereniging / persoon / evenement waarvoor de kandidatuur wordt ingediend Naam: …………………………………………………………………………………………………………………………………………………. Adres: …………………………………………………………………………………………………………………………………………………. Postnummer en plaats: ………………………………………………………………………………………………………………………. E-mailadres: ………………………………………………………………………………………………………………………………………… Telefoonnummer/gsm nr.: ………………………………………………………………………………………………………………….. Bijlagen (optioneel) Aantal: …..
Curriculum Vitae Voorstelling van de (organiserende) vereniging Publicaties i.v.m. het evenement (flyer, poster, inkomkaart, catalogus, persberichte, enz.) Verschenen artikels in de media Beeldmateriaal Andere Vul op de volgende pagina een korte omschrijving van de kandidatuur een motivatie in.
Korte omschrijving van de kandidatuur en motivatie (persoon / evenement of vereniging) (wie – wat – waar – wanneer – budget – doelgroep(en) – belang – publieksbelangstelling – originaliteit – geschiedenis van het evenementen, enz.) ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. ……………………………………………………………………………………………………………………………………………………………. …………………………………………………………………………………………………………………………………………………………….