ANNEX A

(application form)

The Undersigned (surname and name )......

born in …………………..on…………...... , asks to participate in the public competition for

admission to the XXXII cycle research doctorate course

in……………………………...... announced by D.R. n. 288 of 30/06/2016

He declares, under its responsibility, in accordance with the effects of the Presidential Decree n. 445/2000 s.m.i:

a) to be born in ...... (prov. of...... )on ...... ;

to have the following personal identification number (tax code): ...... ;

to reside in ...... prov...... ;

post code...... Street…………………………………..n……………………...... ;

d) to be in possession f the following citizenship: ...... ;

c) to be in possession of the master's degree ( or obtained with the old system) or

an equivalent foreign master’s degree in ...... , achieved on

...... , at ...... with the following grades…………… and n. of

credits………….,

Or

to complete the master's degree(or with the old system) or an equivalent foreign master’s degree by 31st October 2016, under penalty of forfeiture of admission in case of a positive result of the selection in...... obtained on …………………...with the following grade………………and n. of credits………………….;

d) to have adequate knowledge of the Italian language (that declaration must be made only by foreign citizens);

e) undertake to attend full-time the PhD program according to the regulations laid down by the Academic Board;

f) to have the right to a reserved placement being:

an employee having a C or D category or higher

pole act

g) to choose one of the following languages ( Italian or English ) for the oral examination: ...... ;

h)( only for “cellular and molecular Biotechnology” and” Food science” courses) that the research project presented is the following…………………………………………..

( indicate the code of the project indicated in bold in art. 3 and 4 of the competition notice);

i)( Optional only for disabled candidates or candidates who reside abroad )

to choose to have the oral examination via internet through the following skype address……………………………………………………………………………………………………

j) to elect the following address for submission of communications relating to this competition notice

Street address………………………………………………………Post Code ...... City…………………….tel. n...... Mobile Phone n………………………….

e-mail………………………………………….;

Enclose with this application the following documents, provided as required by the notice of competition:

- photocopy of an identity document;

- photocopy of the tax code card;

- Thesis abstract

- Scientific curriculum vitae, dated and signed;

- Letter \ and of reference from university professors or scientific tutors (excluding candidates for the PhD course in "Legal harmonization processes between history and system”);

- research project coherent with the themes of the course (for courses in "Cellular and Molecular Biotechnology" and "Food Science", please refer to the Articles. 3 and 4 of the competition notice);

-self-certification to certify if the annual gross personal income is greater than or lower than

€ 15,000.00 .

(Annexed B of competition notice)

Also attached to this application the following documents: ……………………………..

place and date ......

...... signature

ANNEX B

SUBSTITUTE STATEMENT OF CERTIFICATION

(Art. 46 Presidential Decree 28 December 2000, n. 445)

The Undersigned/ surname...... name...... , born in...... (prov...... ),on...... residing in...... (prov...... ),Street …………………….aware that the falsification of documents and false declarations are punishable, pursuant to art. 76 of Presidential Decree December 28, 2000, n. 445, the Criminal Code and special laws, under its own responsibility

DECLARES

That the annual gross personal income is greater than € 15,000.00

That the annual gross personal income is lower than € 15,000.00

Place and date ...... Signature……………………..