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ONLINE ŽIADOSŤ / ONLINE APPLICATION FORM

Meno autora *

Title of the book in Slovak original *

Slovak publisher's name *

Year of publication *

Translated into (language) *

Title of the book in translation *

Translator's name, address *

His/her achievments as a translator *

Estimated total costs of production:

Translator's fee *

Author's fee *

Printing costs *

The sum of money applied by the publisher in EURO *

The sum of money approved by other grants in Slovakia (FPU, KULT MINOR, BSK, ...) in EURO

Print-run (number of printed copies) *

Hard cover / paperback *

Publisher's price in EURO *

Number of standard pages in translation *

Number of standard pages in original *

Word count or number of verses *

Number of titles published annually *

Publisher's name *

E-mail *

Adresa *

Name of the bank account owner *

Bank account of the publisher (IBAN) *

SWIFT/BIC code *

Name of the bank *

Address of the bank *

Please sign and stamp the Applicacation form and send the original to this address:

Literárne informačné centrum
SLOLIA
Námestie SNP 12
812 24 Bratislava
Slovakia

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Inštitúcia

SLOLIA

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