FUND FOR COOPERATION & KNOWLEDGE IV APPLICATION FORM

Al Magnifico Rettoe
Uni!e"it# $egli %t&$i $i Pa!ia
Il/la sottoscritto/a NAME AND SURNAME chiede di partecipare alla selezione per
lassegnazione di una borsa di studio, nellambito del Programma Fondo per la Cooperazione e
la Conoscenza per lA.A. 2!"#2!$. (The undersigned NAME AND SURNAME asks to partecipate
to the selection to receive a scholarship, through the Programme Fund for Cooperation and Knowledge
for the Academic Year !"#$!"%&'
1. Student Personal Information: (typewrite your data on this form in English)
Family name: First name:
Date of birth: d d / m m /1 9 - - Sex (male/female): M F
Place of birth (city): o!ntry of birth:
"ationality: - select yo!r co!ntry here - - - or here - - - or here - - - or here -
Marital stat!s: sin#le hildren: "o: $
2. Address:
Permanent %ostal address:
S&y%e contact:
ity: o!ntry:
'ele%hone: (mail:

3. Proposed arrival date at the University of Pavia: DD/MM /)$1*
5. References:
+eferee
1
: 'itle s!rname name %hone
fax email
"ame of the !ni,ersity of the referee:
1
-ttach a recent letter of reference d!ly si#ned by yo!r referee (a !ni,ersity %rofessor). +eference sent directly to the /ni,ersity of Pa,ia 0ill
not be acce%ted.
. Academic !ac"#round:
1 #rad!ated 2achelor De#ree in at the /ni,ersity name of the /ni,ersity
Main s!b3ects / Ma3or: 4e,el ---
$ote: %ou must attach copy of the academic transcript of your previous university studies: a
dichiarazione di valore in loco of your transcript &a document issued in Italian 'y the competent Italian
diplomatic authority( )ill 'e re*uired to selected candidates for +nali,in# the enrolment to the
University of Pavia.
-. Proposed .ourse de#ree at the University of Pavia: /aster in select a Master De#ree
0. 1an#ua#e competence: Mother 'on#!e:

5ther lan#!a#es
1 am c!rrently st!dyin# this lan#!a#e 1 ha,e s!6cient &no0led#e to
follo0 lect!res
1 0o!ld ha,e s!6cient &no0led#e to
follo0 lect!res if 1 had some extra
%re%aration
7(S "5 7(S "5 7(S "5
1. (n#lish
).
*.
2. Application form and attachments chec"list: om%lete a%%lication form8 Moti,ation letter8
'ranscri%t of records +ecent letter of reference8 !rric!l!m 9itae ((!ro%ean
format)8
+ecent medical certi:cation8 Photoco%y of %ass%ort/ 1D8 (xcel :le (only for M12()
13. I4 the undersi#ned "-M( S/+"-M(4 con+rm and #uarantee that all the data and information
contained in this application form and in all the attachments are accurate and complete.
Date: DD / MM / )$1* St!dent Si#nat!re:
11. Application form and all the attachments must 'e mer#ed in one P56 +le of /a7. 5 /! named after
the name and surname of the candidate &for e7ample4 name.surname.pdf( and sent 'y email to:
fund.cooperation8unipv.it
4. Attach here a
passport size
picture
5eadline: 13 /ay 2313 ; 1).$$ %.m. (1talian time) late and incom%lete a%%lications 0ill not
be considered
9.andidates applyin# for a scholarship for the /aster in International !usiness and :conomics shall attach4 as
a separate +le4 also the :7cel document do)nloada'le here
2