University of Brescia

Application for PhD Admission in the

PhD Program in Mechanical and Industrial Engineering - DRIMI

Application Form & CV

Fill this form, than save the file, convert it to PDF and rename it as Lastname_DRIMI_ApplicationForm&CV.pdf, then upload it.

PLEASE LIST HERE THE APPLICATION FILES YOU ARE SUBMITTING INCLUDING THE PRESENT ONE:

Lastname_DRIMI_ApplicationForm&Summary.pdf

List name(s) and position(s) of people to whom you asked a letter of recommendation in support of your application

Lastname_DRIMI_StatementOfMotivation&ResearchInterests.pdf

Lastname_DRIMI_ResearchProjectProposal.pdf

Lastname_DRIMI_OtherDocuments.pdf (all attachments must be mounted in a single PDF file)

LastName (as on your passport) ______

FirstName (as on your passport)______

Nationality / Citizenship (as on passport) ______

Date of birth (Day/Month/Year) ______

Gender OMale OFemale

Email address ______

(IMPORTANT: the email address you provide here will be used by the Evaluation Committee in case the Committee decides that it is necessary to contact the applicant to request clarifications on the application material he/she submitted. Should the APPLICANT NOT REPLY to such email request or should the email request result in an ‘undeliverable’ message, the Committee will proceed as if the applicant has not provided satisfactory clarifications and as a result he/she may be excluded from the public competition. Should your email address change after you submitted this form, you must immediately inform this administration of the change, by submitting a replacement Application Form via email to and obtain an email return receipt)

Postal address for correspondence ______

Contact Numbers:

Country Code Area Code Number______

Home______

Business______

Mobile______

Skype name (where to be contacted)______

IMPORTANT: Candidates who opt for being interviewed via Skype rather than by an in situ oral interview, MUST REQUEST SO by filling and filing in PDF also the special REQUEST FORM available on the UniBS website.

Do you wish to be considered for scholarship? ______

Do you have a scholarship from another source? ____

If yes, name the scholarship______

Short description of the candidate

The candidate NAME SURNAME has a BSc in SUBJECT awarded by the NAME OF THE UNIVERSITY with a final grade of GRADE. The candidate has co-authored N publications in international journals and M papers to national or international conferences. So far, he/she has obtained the following awards LIST ALL THE AWARDS OBTAINED.

Your application must include a short research project proposal (in a separate pdf file). This is only for admission examination purpose, it WILL NOT BE your PhD project.

FOR INTERNATIONAL APPLICANTS ONLY

Is English your first language?______

Have you sat an IELTS test?______

Have you sat a TOEFL test? ______(score ______)

Have you completed an alternative English language qualification?______

If yes, attach the results or explain

______

______

List all undergraduate and graduate studies. Attach (in the Lastname_DRIMI_OtherDocuments.pdf, all attachments mounted in a single PDF file) certified copies of transcripts and other documentation.

Degree or professional qualification / Istitution / Place and Country / from year / to year

If you think it is relevant, you may provide below a separate statement (of no more than 500 words) describing your research experience other than from past degrees.

List all relevant work or research experience.

Employment dates / Full or part-time / Position / Organization / Relevant Responsabilities

List any publications, either authored or co-authored. Give complete references. Do not abbreviate; provide full names of journals or books (including page numbers where applicable)

DECLARATIONS

I declare that all the information submitted on this application form and in the attached documents is correct and complete.

I acknowledge that if I provide incorrect or incomplete information this may result in the cancellation of my Offer of Study and/or my enrolment.

I give permission to have my expression of research interest statement and writing sample analysed by plagiarism detection systems.

I HAVE READ AND UNDERSTOOD

the submission of fraudulent or forged documentation in support of this application will automatically disqualify me from enrolment;

meeting the minimum entry criteria does not guarantee me a place at University of Brescia, and if my application is declined, it may not be required to provide reasons;

the information I have supplied with my application will be made available to government entities where required for statistical purposes or where required under Italian law.

The information I supply may be used for purposes relating to my enrolment as a student by members of the academic and administrative staff of Brescia University (including selection committees);

My name and details of any scholarships that I may be awarded may be published;

I have the right to see and correct, if necessary, the information I have provided;

Without this consent, my application cannot proceed;

the declarations contained in the present document;

Place and Date ______

Student’s Signature ______

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