TO THE DIRECTOR OF THE DEPARTMENT

OF MUSICOLOGY AND CULTURAL HERITAGE

CORSO GARIBALDI, 178

26100 CREMONA
______

University of Pavia

The undersigned

Surname

Name
Fiscal code
Place of birth
Province / Country
Date of birth / Sex /

M

/

F

Citizenship
Permanent residence:
Address / N.
City/Town / Province
Post Code / Country
Telephone / Mobile
E-mail

Please, put a cross if your permanent address coincides with your correspondence address 

Correspondence Address (if different):
Address / N.
City/Town / Province
Postal Code / Country
Telephone / Mobile

Please pay attention to provide the right Correspondence Address. Itwill be used to transmit all the communications concerning the selection procedure. Candidates must promptly communicate any change in the contact information.

ASK

To be admitted to the following public selection, based on qualification and oral examination, for the assignment of research grants (see the list of competition codes reported inthe art. 1 of the call for applications)
Scientific disciplinary sector
Competition code
Duration of the research grant (years): /

ONE TWO THREE

In accordance withart.s 46 and 47 of D.P.R. n 445 of December 28th, 2000, (“Unique text of laws and regulations concerning administrative documentation”)

DECLARES, UNDER HIS/HER OWN RESPONSABILITY

A)to have obtained:
 degree(with a course duration of not less than 4 years, as referred to in the pre-existing academic regulations pursuant to D.M. n. 509/1999) in:
 post-graduate degree(pursuant to D.M. n. 509/1999and to n. 270/2004) in:
Academic year / / /
Session
/ / / /
Grade / / /

with honours

Thesis title
Supervisor
University
Faculty
B)to have obtain a PhD degree in:
Academic year / / /

Session

/ / / /
Thesis title
Coordinator
University
C) REQUEST THAT THE FOLLOWING QUALIFICATIONS AWARDED ABROAD BE VALIDATED FOR THE SOLE PURPOSES OF THE SELECTION PROCEDURE AND ATTACH THE DOCUMENTS REFERRED TO IN ART. 4 – COMMA 5 – LETT. C)
D)to be - have been
holder of research grant on:

from

/ / / / / to / / / /
University / Institution
scientific disciplinary sector
E)TO BE IN POSSESSION OF THE FOLLOWING FURTHER QUALIFICATIONS: (DETAIL THE QUALIFICATIONS DEEMED RELEVANT FOR VALIDATION APPRAISAL, ALSO PROVIDING FULL DETAILS OF DOCUMENTS TO ALLOW SELF CERTIFICATIONS TO BE CHECKED
F) TO BE SUFFERING FROM THE FOLLOWING DISABILITY AND REQUIRE THE SUPPORT OF:
G) to be able to attend the language test during the oral examination in the foreign language indicated in the public selection announcement (indicate the language):
H)to have intention to participate in the following research program:
Title
tutor
scientific disciplinary sector
Department/Research Centre in which the research is carried out
I) to be an employee on the following public administration:
J) to not exceed a maximum period of twelve years, even non continuous, considering the total duration of the contracts referred to in art. 22 (research grants) and art. 24 (fixed-term Researchers) of Law 240 of December 30th, 2010, also considering contracts with other universities and/or with other institutions listed in the Art. 22 comma 1 Law n. 240/2010, and the duration of the contract referred to in this selection announcement;
K) to be aware that the University administration does not have any responsibility for missed communications due to wrong information concerning permanent address or contacts, or due to belated or missing notice about variation of the above-mentioned addresses, nor of any postal or telegraphic errors due to third party or to unforeseen and fortuitous events;
L) to communicate immediately, trough registered letter with signed return receipt, any change of residence or contact information occurring after the presentation of the application form;
M) to be aware of the penal sanction in case of false statement, in accordance with Art.76 of the DPR(Italian law) 445 of December 28th, 2000;
N) to be aware of art. 75 of DPR 445 of December 28th, 2000 about the loss of benefits related to the assignment if, after a check, the Administration discovers the untruthfulness of the aforesaid declarations;
O) to allow the University of Pavia to use collected personal data for the selection purposes and for the research grant assignment procedure, in accordance with the D. LGS (Italian Law) n.196, June 30th, 2003 “Legislation concerning the protection of personal data”;
P) to have read carefully the norms contained in the call for application;
Q) to attach the following documents:
1. / A signed and dated scientific curriculum;
2. / List of the scientific publications, detailed description according to the international rules, including all authors;
3. / The publications referred to in art. 4 – comma 11 – lett. c) of the call for applications;
4. / The documents referred to in art. 4 – comma 5 – lett. c) of the call for applications, regarding the validation declaration – for this competition only – of the academic qualifications awarded overseas;
5. / Photocopy of a current ID card.
date / / / / / signature

WARNING:

Application forms non signed, lacking in personal data, statements, documentation, without the exact title of the competition of interest and application forms forwarded after the deadline will not be considered.

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