APPLICATION FORM

Applicants with non-Italian citizenship

no tax stamp (marca da bollo) necessary

To the Headofthe Department of History and Cultures

Alma Mater Studiorum – University of Bologna

I, the undersigned,______, born in (city, country)______, on (dd/mm/yyyy)______, resident in (address) ______, postcode ______, phone:______

HEREBY APPLY

for the research fellowship within the project entitled “Global Humanities and Critical Theory” at the Department ofHistory and Cultures at the Alma Mater Studiorum – University of Bologna.I certify the information provided is correct and I am aware of the civil and penal responsibilities in the event of false declarations.

I HEREBY DECLARE

–I am a citizen of (country)______;

–I do not have a criminal record and am not involved in any current criminal proceedings (or if so, state which) ______

______

–I am in possession of an academic degree from (university or other institution) _______

______

on (dd/mm/yyyy)______which is deemed equivalent.

–I am not related by blood or by marriage up to the fourth degree, to any professor working in the department or structure for which the call is issued, nor with the Rector, Director General or a member of the Board of Governors of the University.

–I have not hold a post-doctoral fellowship at any Italian University for longer than six year (including any grant renewals but excluding any period in which the contract coincided with a PhD program) pursuant to Italian Law no. 240/10

I furthermore request that all correspondence concerning this selection procedure be sent to the following address: ______, and undertake the responsibility to notify of any changes.

I, the undersigned, enclose the following documents with this application:(indicate documents)

–______

–______

–______

–______

–______

Place and date / Signature of the candidate
(required: unsigned application will not be considered)