Scholar application form Application 2022-2023 (*) = Mandatory fields Personal Details First Name* Family name* Date of birth* Day* —Seleziona un'opzione—12345678910111213141516171819202122232425262728293031 Month* —Seleziona un'opzione—123456789101112 Year * —Seleziona un'opzione—1960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002200320042005200620072008200920102011201220132014201520162017201820192020 Birth place* Gender —Seleziona un'opzione—MaleFemaleUndefined Nationality* —Seleziona un'opzione—AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCôte d'IvoireCroatiaCuraçaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard And Mc Donald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall 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StatesUnited States Minor OutlyingUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (U.S.)Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwe Email * Confirm Email* City of residence* Country of residence* —Seleziona un'opzione—AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCôte d'IvoireCroatiaCuraçaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard And Mc Donald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the CongoRéunionRomaniaRussiaRwandaSaint HelenaSaint Kitts And NevisSaint LuciaSaint Vincent and the GrenadinesSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South Sandwich IslandsSouth KoreaSpainSri LankaSt. Pierre And MiquelonSudanSurinameSvalbard And Jan Mayen IslandsSwazilandSwedenSwitzerlandTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor OutlyingUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (U.S.)Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwe Address* Phone* Postal code* Academic Data Title * University of origin* Country of University of origin* —Seleziona un'opzione—AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua And BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCôte d'IvoireCroatiaCuraçaoCyprusCzech RepublicDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard And Mc Donald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the CongoRéunionRomaniaRussiaRwandaSaint HelenaSaint Kitts And NevisSaint LuciaSaint Vincent and the GrenadinesSan MarinoSao Tome And PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South Sandwich IslandsSouth KoreaSpainSri LankaSt. Pierre And MiquelonSudanSurinameSvalbard And Jan Mayen IslandsSwazilandSwedenSwitzerlandTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor OutlyingUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (U.S.)Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwe Host university* Arrival Date in Host university – preference 1* Day* —Seleziona un'opzione—12345678910111213141516171819202122232425262728293031 Month* —Seleziona un'opzione—123456789101112 Year * —Seleziona un'opzione—2023202420252026 Departure Date in Host university – preference 1* Day* —Seleziona un'opzione—12345678910111213141516171819202122232425262728293031 Month* —Seleziona un'opzione—123456789101112 Year * —Seleziona un'opzione—2023202420252026 Arrival Date in Host university – preference 2* Day* —Seleziona un'opzione—12345678910111213141516171819202122232425262728293031 Month* —Seleziona un'opzione—123456789101112 Year * —Seleziona un'opzione—2023202420252026 Departure Date in Host university – preference 2* Day* —Seleziona un'opzione—12345678910111213141516171819202122232425262728293031 Month* —Seleziona un'opzione—123456789101112 Year * —Seleziona un'opzione—2023202420252026 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. I have read and agree to the Privacy Statement