ENCLOSURE A

TO THE RECTRESS OF SAPIENZA UNIVERSITY OF ROME
Academic Programmes and Education Welfare Area
Education Welfare Unit
Certified email: protocollosapienza@cert.uniroma1.it

The undersigned (surname and name) ................................................................................ born in ............................... (province…........) on………………..
Tax Code…………..……..……. resident in ................................................................ (prov.........) Student ID number………………….
street ................................................................................................. (ZIP code ................) telephone number………...................., e-mail address ……………………………...……….
Certified email ……………………………………………………………………………
(with reserve to promptly communicate any changes)

REQUESTS

to participate in the competition for the award of no. …… months of scholarships to attend third-cycle programmes or postgraduate activities to be held abroad reserved to the CUN area no. ........... (please also indicate the title) .................................................................

The undersigned, moreover, aware of the criminal sanctions provided for in case of false declarations
DECLARES, pursuant to Presidential Decree no. 445/2000:
1.	to have the ..........................citizenship;
2.	to hold the master’s degree, single cycle master’s degree or equivalent belonging to …….. class ………. corresponding to the ................CUN Area and to have achieved it as of ...................... with …..... grades from Sapienza University of Rome, Faculty of …………………………………..…………….………….;
3.	to know the language/s required by the receiving institution;
4.	not to have previously benefitted from any other scholarship to attend third-cycle activities;

UNDERTAKES

a)	not to benefit at the same time from other scholarships awarded at any title, except those awarded by Italian or foreign institutions in order to integrate the training of scholarship holders with periods of study abroad, and in case to waive such scholarships;
b)	if holder of scholarships for PhDs, PhDs in co-tutorship, specialisation schools or advanced professional courses, to waive the enrolment in the above programmes/activities before leaving;
c)	to perform third-cycle activities in a country other than that of origin;
d)	to communicate whether their gross overall personal income exceeds the amount of € 7,750.00 in the year of enjoyment of scholarship and to repay the relating amounts already received;
 
The declarant expressly agrees to the provisions of letters a), b), c) and d) and is aware that failure to keep the commitments undertaken, they will forfeit the right to enjoy the scholarship and the relating benefits achieved, if any, with the following obligation to repay the sums received, if any.

The undersigned attaches hereto:

1.	the formal documentation issued by the foreign or international academic institution located abroad where candidates wish to go (or a statement, on headed paper, of a teacher of the same institution), showing the candidate’s acceptance, or intention to accept, the postgraduate activity or the third-cycle programme.
The above formal documentation shall show: 
•	in case of a third-cycle programme, its name, duration and structure;
•	in case of a postgraduate activity, its programme.

2.	Enclosure B including the self-certification with the list of the acquired qualifications and of publications, with the description of their contents, an abstract and all details of the journal and of the ISBN, ISMN, ISSN or DOI codes;

3.	translation into Italian of the documentation issued by the foreign or international institution as per point 1 (only required if the document has been issued in a language other than English)

It is not necessary to undersign this application as it is sent by means of the candidate’s certified email

PLEASE NOTE:
The declarant is criminally liable in case of false declarations (art. 76 of Presidential Decree of December 28, 2000, no. 445). The declarant forfeits the benefits achieved, if any, in case of untrue declarations (art. 75 of Presidential Decree of December, 2000, no. 445).