Facsimile of application form 

To the Head of the Department of Political Science, Law, and International Studies
University of Padova

I, ____________________________________________________________________ [full  name]
born in __________________________________________________________________[city and nation]  on__________________, resident at _____[full address], social security No.(or equivalent)  ________________________________ and having telephone no.  _________________________, 
e-mail address _______________________  and certified e-mail address: _____________________

HEREBY REQUEST
to be admitted to the selection process for the awarding of a research visiting fellowship, within the Project “La promozione delle energie rinnovabili nelle imprese venete: strumenti e tecniche normative a livello europeo e realtà locale” project code 2105-49-11-2018.
Research n. 3: The European Union Towards a Low- and Clean-Energy Economy through the evaluation of qualifications.
The selection process has been authorised by provision of Reg. no. 72/2019 Record no. 1011 of 24th May 2019.
Aware of criminal liability in the event of false or incomplete statements, pursuant to Italian Presidential Decree 445/2000 I 
HEREBY DECLARE
•	to possess the following qualifications:
 _____________________________________________________________________________
•	to be a citizen of  _____________________ 
•	[for non-European citizens, living in Italy] to have a valid residence permit on the date of the application 
•	not to be married or related to, or have an affinity with, up to and including the fourth degree of kinship, a professor or researcher working at the Department of Political Science, Law, and International Studies, the University Rector, the University Director General, or a member of the University’s Board of Governors.
•	to be working as  ______________________________________________________
•	to be aware that personal data will be collected and processed in compliance with UE Regulation of 27.04.2016 n. 679 (General Data Protection Regulation - GDPR).

The address for communications regarding this selection is:
o	my Home Address
o	the following address:
_______________________________________________ [street and no.], _______________________________________________ [city], _______________________________________________ [country] 
_______________________________________________ [postcode]
_______________________________________________ [nation]

As required by the selection announcement I enclose:
a) my CV detailing professional, academic and research background;  
b) a copy of my identity document;
c) [any other documentation as indicated in the selection announcement]
d) [any other documentation deemed relevant for the evaluation]

Date__________________________

Applicant's signature

________________________________________________