Scholar application form – Seas 4.0

(*) = Mandatory fields

Personal Details

First Name*

Family name*

Date of birth*

Day*

Month*

Year *

Birth place*

Gender

Nationality*

Email *

Confirm Email*

City of residence*

Country of residence*

Address*

Phone*

Postal code*

Academic Data

Title *

University of origin*

Country of University of origin*

Host university*

Arrival Date in Host university – preference 1*

Day*

Month*

Year *

Departure Date in Host university – preference 1*

Day*

Month*

Year *

Arrival Date in Host university – preference 2*

Day*

Month*

Year *

Departure Date in Host university – preference 2*

Day*

Month*

Year *

Upload file

All files must be uploaded in pdf format – limit 3 MB

UPLOAD YOUR CV*

UPLOAD YOUR LECTURES PROPOSAL*

Declaration

Participants with special needs
NoYes

If you have a disability (visual difficulties, hearing or speaking difficulties, learning difficulties) or special requirements, you should give us full details of your needs and provide a medical certificate. For some special arrangements to be made for you, you should send an e-mail to the address infomasterseas40@unina.it, within and no later than 14.00 am (GMT+1) of 15/02/2021.

I confirm that I filled in this form truthfully and to the best of my knowledge. I also confirm the authenticity of all documents handed in.

I CONFIRM

The candidate hereby declares under his/her sole responsibility that the information provided is true. In case any of the above information is found to be false or untrue or misleading or misrepresenting, the candidate is aware that he/she may be held liable for it.