Application form

Appendix № 2
to the Regulations on the procedure of competitive
selection of creative works for the issuance of
the State signs of postal payment

Sample

Application form

to FSUE Publishing and Trading Centre “Marka”

for the participation in the Contest of creative works

for issuance of the State signs of postal payment

1.                           _______________________________________________________________________________________

Type of product and theme

2.                           _______________________________________________________________________________________

Last name, first name and patronymic (middle) name of the author 

3.                           _______________________________________________________________________________________

Date and year of birth

4.                           _______________________________________________________________________________________

Place of Employment (optional)

5.                           _______________________________________________________________________________________

Education (optional)

6.                           _______________________________________________________________________________________

Detailed postal address (with postcode)

7.                           _______________________________________________________________________________________

Contact phone number (with code)

 8.                           _______________________________________________________________________________________

E-mail address