Public Selection for the Awarding of a Research Grant

ANNEX A

PUBLIC SELECTION FOR THE AWARDING OF A RESEARCH GRANT

APPLICATION FORM

FOR THE ATTENTION OF THE RECTOR

UNIVERSITY OF CAGLIARI

T.A.A. Public Competitions Area

Via Università 40

09124 Cagliari

I, the undersigned

Name(s)……………………..………………….. Surname………………………………………………

Place of birth (Town/State)………………………………………………………………….……………

Date of birth (dd/mm/yy)…………………………………………………………………………………

Nationality………………………………………………………………………………………………..

Permanent residence address (number/street/town/post code/country):

……………………………………………………………………………………………………………

Domicile (if different from the residence) in (number/street/town/post code):

…………………….……………………………………………………………………………………..

Tel./Mob………………………..……………………………………………………………………….

Tax Code……………………………………..…………………………………………………......

Email address……………………………………………….………………………………………….

intending to promptly communicate any change in the above said contact information

ASK

to be admitted tothe selection on qualifications and interview for the foreign language test in order to be awarded the following specified research grant:

AREA:
Examination section:
Scientific Manager:
Title of the Project:

To this end, I, THE UNDERSIGNED, under my own responsibility, declare:

1)that I hold the Ph.D. awarded by………………………………………………….…………………….

on (date)………………at………………………………………………………………….……..…….

that I hold a degree in………………………………….awarded by………………..………..

on (date)………………………………with the following grades……………….…………..

andthat I have been awarded one of the following scholarships or contracts (tick the related box):

- research grants and international or national advanced training courses:

(specify):……………………………………………………………………………………….

………………………………………………………………………………………......

- regional fellowships pursuant to the Law nr. 7 of 7th August 2007 (specify):

………..………………………………………………………………………………………..

………………………………………………………………………………………………….

- previous research contracts, even non continuative ones, for no less than two years(specify):

………………………………………………………………………………………………….

…………………………………………………………………………………………………

2)that I hold a B1 level certification for the knowledge of the English language, or a corresponding certification for any other foreign language (specify and/or enclose certification in attachment - if the applicant does not hold any certification, the knowledge of the language will be assessed during the interview):

……………………………………………………………………………………………………………………………………………………………………………………………………

3)that I have never been sentenced nor am I currently prosecuted or:

(specify any possible sentence or pending prosecution)

…………………………………………………………………………………………………………………..……………………………………………………………………………….

4)that I have never had any contracts for research grants pursuant to the art.22 of the Law 240/2010 whose duration, added up to the grant awarded in this call, exceeds the limit of six years (apart from any possible time coincidingwith the attendance of the Ph.D);

5)that I have no family link and up to three times removed kinship(Art. 18, lett. B Law240/2010) to any teacher member of the University proposing the project or to the Rector, the General Manager, or any other member of the University Administration Board;

6)that the duration of this grant, added up to the contracts benefited by theundersigned,pursuant to the art. 2, par. 4 it. C of the call, does not exceed twelve years;

7)that I have enrolled in the following……………………………………………......

(specify any possible enrolment in degree courses, honours degree or masters degree, Ph.D., or medical specialisation with scholarship, university masters);

8)that I amcurrently engaged with …………………………………………………………..….

(specify any possible working relation, subordinate or free-lance, currently held);

9)that I do not hold any further grants, awarded for any reason, and I pledge to renounce it if I pass this selection;

I, the undersigned, enclose the following:

professional scientific curriculum;

self-certification, issued pursuant to the D.P.R. 28.12.2000 nr.445 as for the possession of the required qualifications;

publications;

any documents related to any qualificationawarded in a foreign country and eligiblefor the selection (see art. 3, it. e of the selection call);

form to apply for the interview via Skype (Ann. D – only for candidates residing or domiciled in countries out of the Sardinian territory);

colour photocopy of the identity card.

DATE…………………………………….

SIGNATURE (full and legible name)

______

Ann. B

SELF - CERTIFICATION

(Art. 46, D.P.R. 28th December 2000, nr.445)

I, the undersigned………………………………………………born in……………………., Prov. (……)on…………………..……..residing in …………………………………….…………Prov. (…) (full address)……………………….nr……………………. Post code…………………., privy to what statutory in the art. 76 of the D.P.R. 28th December 2000, nr. 445, about the criminal liability as for forgery and false declaration, in accordance and as aresult of the above said D.P.R. nr. 445/2000 and under my own responsability

DECLARE

(tick the related box)

that I have a degree in…………………………..awarded on………………with the final grades………………..on a thesis entitled………………………………………………………………

that I have a Ph.D. in……………………………………..…….awarded on……………..with the evaluation……………………….at…………………………………………. with a thesis entitled ………………………………………………………………….

that I have a specialisation in ……………………..awarded on………………at………………………………………………………………….

that I have the following attendance certificates at post degree specialisation courses……………………………………………………………………………...

that I have carried out a research in public and private institutions with contracts, fellowships or other assignments, either in Italy and abroad (specify the related dates)…………………………………………………………………………………………………………………………………………………………………

that I have held previous contracts for research grants ex. 449/97 or ex 240/2010 or previous contracts as a researcher of the type a) or b) pursuant to the art. 24 of the Law 24072010:

Type of contract:……………from………to……………..(years/months altogether);

Type of contract…………….from………to………………(years/months altogether)

that I also have the following qualifications eligible for the selection:

………………………………………………………………………………………………………………………………………………………………………….

I acknowledge, in accordance with and as a result of what statutory in the art. 13 of the D.L. 30th June 2003, nr. 196, that the required personal data will be processed, even through information systems, only with reference to the procedure this declaration has been issued for.

READ, APPROVED AND SIGNED

THE DECLARANT

Signature (full and legible name)

Cagliari, (date)……………………………………

Ann. C

ATTESTED AFFIDAVIT

(to be signed before the person in charge or to be sent with the photocopy of an identity document enclosed)

(Art. 47, D.P.R. 28th December 2000, nr. 445)

I, the undersigned, born in…………………….on…………………………….residing in…………………and domiciled in ……………………..(full address)…………….., privy to what statutory in the art. 76 of the D.P.R. 28th December 2000, nr. 445, on the criminal liability as for forgery and false declaration, in accordance with and as a result of the above said D.P.R. nr. 445/2000 and under my own responsability:

DECLARE

that the photocopy ot the following document/s attached to this declaration is compliant to the original document:

1)………………………………………………………………………………………..

2)…………………………………………………………………………………………

3)…………………………………………………………………………………………..

4)…………………………………………………………………………………………..

5)……………………………………………………………………………………………

6)…………………………………………………………………………………………….

Read, approved and signed:

THE DECLARANT

(full and legible name)

Cagliari (date)------

Ann. D

FORM TO APPLY FOR A VIDEO CONFERENCE VIA SKYPE

(only for applicants residing or domiciled out of the regional territory)

SURNAME______

NAME______

PLACE OF BIRTH______

DATE OF BIRTH______

NATIONALITY______

GENDER______

PERMANENT RESIDENCE (address, number, post code, country)______

TELEPHONE______

SKYPE ID______

E-MAIL______

ASK

to be interviewed through videoconference via Skype.

I acknowledge what statutory in the art. 76 of the D.P.R. 28th December 2000, nr. 445, on the criminal liability as for forgery or false declarations, and as aresult of the above said D.P.R. 445/2000 and under my own personal responsability I

DECLARE

that for my identification I will apply to the Identity Card/Passport attached in a back and front colour copy.

DATE______

SIGNATURE______