Application Form
School of European Legal and Social Studies (S.E.L.S.S.)

Please fill out in block capital letters (all the fields are mandatory: incomplete applications will not be taken into account). 
Please attach to the present Application Form your detailed CV, one motivation letter, one letter of recommendation and one scanned copy of your ID card or passport. All documents have to be sent to selss.dirpubblico@unipd.it no later than 26th July 2013, 12.00 a.m. GMT +1.

A) Student Information (
Family Name ______________________________________________________
First Name _________________________________________________________Gender_______________
Birth Date (MM/DD/YYYY)_________________________________Place of Birth (city)__________________
Place of Birth (Country)	_________________________________Citizenship__________________________
Permanent address (street name, zip code, town, country) ______________________________________________________________________________________________________________________________________________________________________________
Mobile phone number (including country and area code)_______________________________________
E.mail_____________________________________________
Passport / ID Number___________________________________________________________________

B) Request for scholarship (Yes/No)

Information according to article 13, D.Lgs 196/2003. According to this Italian law provision, individuals and other subjects are protected against any unwillingly use of personal data; therefore, any personal information you submit will be treated in accordance with the principle of just use, legality and with full respect for your privacy and other rights. Personal data provided by the participants will be treated and kept by Università degli Studi di Padova. You have the right to rectify, integrate or request the deletion of provided data – art. 7 and following, D. lgs. 196/2003 – simply requesting it to Università degli Studi di Padova by sending an email to selss.dirpubblico@unipd.it. Providing personal data is facultative, but without the necessary data we won’t be able to provide the required services. After reading and understanding the present information notice, I explicitly agree on the above, and I declare that the given data are true and corresponding to my identity. I also declare to have read and fully understood the terms and conditions set out in the regulation of the SELSS.
Place and date_______________
Signature