FORM A

APPLICATION FORM for the selection of n° 2 positions as “exchange-students” for a semester at the sir sandford fleming college, ontario (canada)
YEAR 2016

surname………………………………………  name  ………………………………………………
enrolment n°(matricola) …………………………………………………….
telephone number …………………………………………………………
e-mail address   …………………………………………………………
degree course  …………………………………………………………
year (first, second or third) ……………………………………………
n° of credits achieved (within the date of application)…………………… ……..
Period of activity ouside the country  ………………………………………………………
activity (Studying, training, thesis research)………………………………………………………

TUTOR PROFESSOR OR SUPERVISOR ……………………………………………………………..

									STUDENT’S SIGNATURE
								………………………………………
Date:	…………………………………………	

Enclosures:

-	List of exams (through self-certification in UNIWEB; students enrolled in Laurea Magistrale courses will also include self-certification of the Laurea Triennale degree with exams list and votes)
-	Tutor professor’s/supervisor’s declaration (indicating kind and period of the activity to be carried out)
-	English proficiency certification

Application forms duly signed and enclosures have to be delivered at the Department of Land, Environment, Agriculture and Forestry - 2nd floor - 1st stecca - not later than 18th April 2016, 13.00 am (ref. Sara Ziggiotti)

For further information: sara.ziggiotti@unipd.it