Traditions and Modernity June 20-23, 2024 ⁕ Moscow ⁕ Russia ⁕ Painting Graphics Sculpture Sculpture Photography Architecture Applied Art Mask Puppet Installation Digital Art Museum Business

Ticket refund form

To the Head of the Moscow Public Foundation

support of culture and development of contemporary art

Kiseleva V.N.

От:____________________________________________________

Адрес проживания:______________________________________

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Паспорт: Серия________________№_______________________

Contact phone number :____________________________

APPLICATION


Please return the money to the payment card

___________________________________________

(map name)


of the map:

*

*

*

*

*

*

*

*

( Specify the number of the payment card from which the order was paid. First 6 and last 4 digits)


For paid tickets through the website

_________________________________________________________________

В сумме­­­­­­­­­­­­­­­­­­­_______________________ (________________________________________) руб.

(Amount in words)

Транзакция №______________________Заказ №________________________

На мероприятие________________________________________________________________

(name of activity)

________________________________________________________________________________________________________

(date of event)

В связи__________________________________________________________________________________________________

(specify reason))

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Date “______”__________________ 20_____.

Caption
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