DECLARATION IN LIEU OF CERTIFICATION
(ITALIAN PRESIDENTIAL DECREE 28 DECEMBER 2000, NO.445, ARTICLES 46 AND FF. AND LAW NOVEMBER 2011, NO.183, ARTICLE 15)
Laurea magistralis degree course in Science and Technology for Population Health and Wealth
A.A. 2016-2017
Tax Code: |__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|__|
The undersigned ______
born in ______(province: ______.)
on ____/____/______,
resident of (street name) ______
no. ______
Municipality ______(province: ______.), Post code. ______
Nationality ______
Telephone no.: ______Mobile no.: ______
E-mail: ______
DECLARES ON HIS/HER OWN RESPONSIBILITY:
- EDUCATIONAL QUALIFICATION Art. 2 para. a) (check and fill the relevant option)
□ to have passed the degree examination in ______
degree class ______at the University of ______
(code, name and M.D.)
on ____/____/______, with a mark of ______/______;
□ to be about to take the degree examination in______
degree class ______at the University of ______
(code, name and M.D.)
on ____/____/______,
□ to have obtained the three-year university degree in ______
degree class ______at the University of ______
(code, name and M.D.)
on ____/____/______, with a mark of ______/______;
□ to have obtained or be about to obtain on __/__/____ the following FOREIGN university degree qualification______
with a mark of ______at the University of ______
Country: ______
ATTENTION: EU and non-EU citizens in possession of an education qualification obtained abroad will be admitted subject to confirmation. Their enrolment will be subject to the validity of the documentation in their possession regarding the educational qualification obtained abroad, whether it be a university qualification or a high school qualification as provided for by the regulation in force and by the Italian Ministry of Education, Universities and Research's of 20/04/2016. The qualifications declared with details of exams sat shall be accompanied by an enrolment application appropriately including original 'Dichiarazioni di Valore' (Declarations of Value) drawn up by the competent Italian Diplomatic Authorities. Enrolment will be also subject to checks by the Examining Board on the suitability of the candidate's preparation in the subject matters deemed essential for admission into the course of study (see the SSD - scientific and disciplinary sectors listed in point 2.
THE UNDERSIGNED ALSO DECLARES:
- that the normal length of abovementioned course of study is _____ years;
- to have enrolled on ____/____/______in the first year of the abovementioned course of study in the academic year
______/_____
► TO HAVE OBTAINED A HIGH SCHOOL DIPLOMA ______(□ five-year □ four-year)
in the academic year______with the mark ______□ honours
at the school: ______
□ state school □ legally recognised school
Address: ______
Municipality ______(province: ______) Post Code. ______
If the declarant has attained a high school qualification abroad, the declarant must send with this application the original copy of the qualification, with an official translation in Italian issued by the competent Italian Diplomatic Authority in the country where the qualification was obtained.
- ADMISSION TITLES Art. 2 para. a)
THE UNDERSIGNED DECLARES OF HIS/HER OWN RESPONSIBILITY
to have attained at least 50 University credits in the scientific and disciplinary sectors listed below following the pass result of the exams indicated: BIO/06-COMPARATIVE ANATOMY AND CYTOLOGY; BIO/09-PHYSIOLOGY; BIO/10-BIOCHEMISTRY; BIO/11-MOLECULAR BIOLOGY; BIO/12-CLINICAL BIOCHEMISTRY AND CLINICAL MOLECULAR BIOLOGY; BIO/13-APPLIED BIOLOGY; BIO/14-PHARMACOLOGY; BIO/16-HUMAN ANATOMY; BIO/17-HISTOLOGY; BIO/18-GENETICS; CHIM/03- GENERAL AND INORGANIC CHEMISTRY; CHIM/06-ORGANIC CHEMISTRY; CHIM/10-FOOD CHEMISTRY; FIS/07-APPLIED PHYSICS (TO CULTURAL AND ENVIRONMENTAL ASSETS, BIOLOGY AND MEDICINE); MAT/05-MATHEMATICAL ANALYSIS; MAT/07-MATHEMATICAL PHYSICS; MED/01-MEDICAL STATISTICS; MED/03-MEDICAL GENETICS; MED/04-GENERAL PATHOLOGY; MED/05-CLINICAL PATHOLOGY; MED/07-MICROBIOLOGY AND CLINICAL MICROBIOLOGY; M-EDF/01 DIDACTIC METHODS FOR MOTOR ACTIVITY; M-EDF/02 TEACHING METHODS FOR SPORT; MED/45 GENERAL CLINICAL AND PAEDIATRIC NURSING SCIENCE; MED/46 MEDICAL AND LABORATORY TECHNIQUES; MED/47 OBSTETRICS AND GYNAECOLOGY NURSING SCIENCE; MED/48 NURSING SCIENCE AND NEUROPSYCHIATRIC AND REHABILITATION TECHNIQUES; MED/49-APPLIED DIETETICS; MED/50-APPLIED MEDICAL SCIENCE AND TECHNIQUES.
Scientific and Disciplinary Sector (SSD) / Exam title / Exam date / Credits / Mark- EU and non-EU citizens with a qualification obtained abroad will have to include suitable documentation so that the Examination Board is able to evaluate the suitability of the candidate's preparation regarding the subject matters deemed essential for admission into the course of study (see the SSD - scientific and disciplinary sectors indicated in point 2.
- LANGUAGE CERTIFICATION Art. 2 para. d)
THE UNDERSIGNED DECLARES OF HIS/HER OWN RESPONSIBILITY
- to be the holder of an English language proficiency certificate of level ______
obtained at ______on ____/____/______
Address ______no. ______Municipality ______(province ______)
- to have obtained the following qualification in English ______obtained at ______on ____/____/______
Address ______no. ______Municipality ______(province ______)
- to have acquired, in his/her university curriculum, an English language proficiency level equal to or greater than B2 (specify)______
- to come from an English-speaking country (specify which one and the years of residence)______
The undersigned is aware that issuing false declarations is punishable under
the Criminal Code and applicable specific laws pursuant to articles 75 and 76 of the Italian Presidential Decree
445/2000. The undersigned is aware of the provisions in art. 13 del Italian Legisaltive Decree 196/03
(“Data Protection Law”).
Brescia, ______/______/______
______
(signed by the declarant )
A front and back photocopy of the identity document currently being validated is attached
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