Author: utente
Last saved by: Francesco Guzzo
Company: UNIGE

University grant
 Department grant
 External Body grant
 MIUR grant ex DM 198/03 – priority research ambit____________________________________
________________________________________
 Non grant holder doctoral student

REVENUE STAMP
(MARCA DA BOLLO)
€ 14,62
(only for grant holders)

AL MAGNIFICO RETTORE DELL’UNIVERSITA’ DEGLI STUDI DI GENOVA

I (Surname).............................................................................................................................................……………………

(Name)..................................................................................................................................................…………………….

hereby apply for admission at the first year of the Ph.D. course in......................................................................………….

Field (if applicable):...............................................................................................................................................................

of the School: ................................................………........................………........................……….....................................
XXVIIIth  Cycle

as:

 grant holder student			or					 non grant holder student

and state, as per art. 46 of the D.P.R. n. 445 of 28 December 2000 concerning substitute certifications:

a)	That I was born in (Province or Country)....................……………........…................................................................... (City)………………………..….............................................on (day/month/year)…………………………...............
b)	That I am a/an......................................................................................................................…citizen (state citizenship)
c)	That I am resident in (Province or Country)....................………………………………………………...……........…
(City)………………………..….............……………………………………….Postal Code n.. ..........………..……..
Full address……………………………………………………………………………………………… n. .................
telephone n…………………………….……Mobile phone n.………………………………………………...………
email……………………………………………………………………………………………………………………
d)	That I hold the following Italian qualification:
Laurea Specialistica/Magistrale, obtained in accordance with the new system in......................................................... ..…………………………………………………………………………...........Class……………………..................
at ……………………………………………… with the following mark ………….., date ………………………..;
or
Diploma di Laurea, obtained in accordance with the pre-existing rules in.................................................................... ………………………………………………………………………………………………………………………….  at.........................................................................with the following mark………………………,date……………….;
or
that I have the following qualification ………………………………………………………………………………..
obtained from a foreign University............................................................................................. and which has already been declared equivalent to a Laurea (in the latter case indicate the Order with which equivalence was declared): 
the Chancellor’s Decree which states the equivalence ………………………………………………………………..;
or
that I have the following qualification in ……………………………………………………………………………
obtained at …….……………………………………………………………………………………. in (Country) ………………………………………………… with the following mark ………….., date ………………………..;
recognised as equivalent, for the sole purpose of being admitted to the course, by the Assembly of Lecturers of the Doctoral School/ Doctoral Research Course
e)	I undertake to attend the Doctoral course full-time;
f)	I am not enrolled in:
•	Another research Doctoral course;
•	Any other study course which assigns an academic qualification, even though from another University.
or
I am enrolled on a medical specialization course in........................................................................................................
At....................................................................................year of enrolment....................................................................
g)	I am holder of the following  benefits:
	 Research grant holder, at the University of……………………………………………………................................
	Period: from……………………………………………………to ……………………………………………...........
	 Public employee on paid leave 

The grant holders shall also declare (checking the boxes);
	I have never been awarded grants for doctoral studies before;
	My expected total gross annual income for year 2013 does not exceed € 13,000.00 and I am aware that incomes are calculated on all kinds of incomes or emoluments. If I should exceed the income limit I undertake to give immediate written notice to the Admistrative Head of the University of Genova. 
 	I will not add this grant to any other grant whatsoever except for those awarded by national or foreign institutions which may help to integrate the doctoral research activities with trips abroad (as for art. 6, paragraph 1 of Law 398/89)
 	I undertake to show, with self-certification , my total annual income about year 2013;
 	I agree to return the grant payments received if I exceed the income limit.
OR
	I forfeit the grant for all the duration of the course;
	I forfeit the grant for the first year of the course, as my expected total gross annual income for year 2013 does exceed € 13,000.00;
	I forfeit the grant for the first year of the course, as I am holder of a research grant.

Enrolment applications should also include:
•	the receipt of the enrolment on the public exam, duly signed by the applicant;
•	a photocopy of an identity document, back and front;
•	for non grant holders student: the receipts of the payment of the first instalment of the enrolment and attendance fee equal to € 452,62, and the regional right-to-study tax, € 160,00;
•	the form for the release of University ID card (with a passport photo);
•	if the qualification was obtained at a foreign University, the student must enclose the following documents:
a)	translation of the academic qualifications duly notarized by the Italian diplomatic or consular office of the country in which the qualifications were achieved;
b)	“Declaration of Worth” of the qualifications drawn up by the same consular body.

The undersigned is aware of the criminal punitive measures as per art. 76 of the D.P.R. No. 445 of 28 December 2000 for false declarations.

Genova, .............….........................[date]				SIGNATURE___________________________

Information for the students of the University of Genoa
(Legislative Decree No. 196 of 30 June 2003 – Privacy-code concerning the protection of personal data, hereafter referred to as Privacy-code)
PROCESSING PURPOSES AND METHODS 
The data provided by you on enrolment shall be used by the University of Genoa and by its administrative offices. The data shall be processed exclusively for institutional purposes and according to the general principles of transparency, correctness and not in excess in compliance with the rulings of art. 11 of the Privacy-code and of the implementation rules and internal regulations (in particular as per the Chancellor’s Decree n. 198 of 11.07.2001 containing the “Rules and regulations concerning the processing, communication and transmission of personal data” and as per the Chancellor’s Decree n. 165 of 12.04.2006 containing the “Rules and regulations for the processing of sensitive and legal data in compliance with the Legislative Decree 196/2003”).
The processing of the data shall take place by suitable means to adequately guarantee safety and privacy and, generally, it will also be carried out using electronic means capable of saving, managing and transmitting the data. The ways in which the data are processed may involve the use of information technology and automatic instruments capable of linking the data also to other data of other individuals, based on qualitative, quantitative and temporal criteria, recurrent and/or to be defined each time.  
DATA PROCESSING
The processing of your personal data will be in compliance with the rules and regulations of the Privacy-code and, in particular, with articles 18 and 19 of the aforementioned code. In particular, your data may be communicated to:
- Certifying administrations, when controlling substitute statements given according to the D.P.R. (Decree of the President of the Republic) n. 445/2000;
- Institutions, public and private companies and professional firms, for the orientation and insertion into the working world, except for an explicit request to the contrary of the individuals involved, addressed to the DIPARTIMENTO STUDENTI (Student department), via Bensa 1, 16123 – GENOVA (Art. 24 – common, transitory and final provisions, paragraph 5 of the University Rules and Regulations for Students);
- The Foreign Ministry, Police Headquarters, Embassies, the Public Prosecutor’s Office, concerning residence permits or the recognition of particular statuses;
- The Municipality of Genoa, the Region of Liguria, their managing institutions and other institutions, to favour – in particular – student mobility, to carry out the evaluation of economic benefits, the assignment of accomodation, the finding of living solutions for students; 
	- Judicial Authorities and police forces;
	- Other public or private subjects to whom the University assigns its services in outsourcing. 
NATURE OF THE DATA
The provision of personal data is compulsory, except for the communication to Institutions, public and private companies and professional firms, for the orientation and insertion into the working world. Any refusal will make it impossible to carry out the necessary activities to create a relationship between the student and the University. Furthermore, the refusal makes it impossible for the University to carry out the correct administrative and didactic management of students’ careers necessary to accomplish the obbligations imposed by the law.
SUBJECTS OF DATA PROCESSING
The recipient of the data provided by you is the University of Genoa, in Via Balbi 5, in the person of its legal representative. Those responsible for the processing of your personal data are the people responsible in the various administrative, didactic, research and service structures. The names of the people responsible for the abovementioned structures can be found in the website www.unige.it. 
THE INDIVIDUAL’S RIGHTS
With reference to the abovementioned processes, the undersigned may exercise his/her rights as per art. 7 of the Privacy-code. 
Having read the above

Genova, ..........…………………………….[date]			SIGNATURE___________________________