FICHA DE INSCRIÇÃO

NOME COMPLETO DO AUTOR: _______________________________________________________________________________ RG:__________________________________________________ CPF:________________________________________________ IDADE:______________________________________________

EM CASO DE MENOR DE 18 ANOS, PREENCHER: NOME DO REPRESENTANTE LEGAL:___________________________________________________________________________ RG:_________________________________________________ CPF:________________________________________________

ENDEREÇO:______________________________________________________________________________________________ CEP:___________________________ BAIRRO:____________________________ CIDADE:____________________ UF:________ TELEFONE:________________________________________________________________________________________________ EMAIL:___________________________________________________________________________________________________

TÍTULO DA OBRA:_________________________________________________________________________________________ PSEUDÔNIMO DO AUTOR:__________________________________________________________________________________