unicri.itunicri.it/in_focus/files/application_form_migration_and_hu… · web view11. in regards...
TRANSCRIPT
APPLICATION FORM
Summer Course on Migration and Human Rights13 – 17 July 2020
Standard Application Deadline: 1 July 2020
Early Birds Deadline: 31 March 2020
Please complete all the information required below, do not omit any information.
Your application cannot be processed unless it is complete.
Please fill in this application form in Microsoft Office Word format.
A. PERSONAL INFORMATION (AS INDICATED IN YOUR PASSPORT)1. Surname/Family Name (as indicated in your passport)
First Name (as indicated in your passport)
Other names (as indicated in your passport)
2. Date of birth (dd/mm/yyyy) / /
3. Place of birth
4. Nationality at birth
5. Present nationality
6. Gender Male Female
7. Permanent address
E-mail (it will be used to communicate the selection results):
Home Telephone (+ country/area code):
Mobile phone (+ country/area code):
Skype-id:
8. Present address (if different from permanent address)
Home Telephone (+ country/area code):
Mobile phone (+ country/area code):
9. Person to notify in case of emergency
Name:
Address:
Home Telephone (+ country/area code):
Mobile phone (+ country/area code):
E-mail:
Application FormSummer Course on Migration and Human Rights 2020
1-5
B. LANGUAGE PROFICIENCY
10. Knowledge of languages
What is your mother tongue?
READ WRITE SPEAK UNDERSTAND
Other languages Easily Not Easily Easily Not Easily Easily Not Easily Easily Not Easily
11. In regards to my English language proficiency, I declare that:
English is my mother tongue.
I hold a first or higher degree from an institution in which English is the primary language.
I hold an official English certificate (e.g. Cambridge, TOEFL, IELTS, other).
I do not have any English certificate. However, I hereby certify that my level of English (both spoken and written) is suchas to allow me to understand lectures and actively participate in classroom debates. I understand that a phone interviewcan be arranged in order to assess my English language proficiency.
C. EDUCATIONGive full details, please list in reverse order.In Column C, please give exact titles of degrees in original language.In Column D and E, please translate titles of degrees and final dissertation in English (if necessary).
12. University or equivalent
A B C D E
NAME, PLACE AND COUNTRYATTENDED FROM/TO DEGREES AND ACADEMIC
DISTINCTIONS(IN ORIGINAL LANGUAGE)
DEGREES AND ACADEMIC
DISTINCTIONS(IN ENGLISH)
FINAL GRADE AND TITLE OF FINAL DISSERTATION(IN ENGLISH)mm/yyyy mm/yyyy
/ /
/ /
/ /
13. Specialized courses or other formal training (i.e. technical school or apprenticeship)
NAME, PLACE AND COUNTRY TYPE(IN ENGLISH)
ATTENDED FROM/TO CERTIFICATES OR DIPLOMAS OBTAINED
(IN ENGLISH)mm/yyyy mm/yyyy
/ /
/ /
/ /
Application FormSummer Course on Migration and Human Rights 2020
2-5
D. PROFESSIONAL EXPERIENCE
Please list any relevant present/previous work experiences (internship positions included) in reverse order.
14. Employment record
14.a - PRESENT POST (last post if not presently in employment)FROM(mm/yyyy) /
TO(mm/yyyy) /
EXACT TITLE OF YOUR POST:
EMPLOYMENT TYPE:
Permanent Temporary Consultant OtherNAME OF EMPLOYER (Type of Business):
FIELD OF WORK:
14.b - PREVIOUS POSTFROM(mm/yyyy) /
TO(mm/yyyy) /
EXACT TITLE OF YOUR POST:
EMPLOYMENT TYPE:
Permanent Temporary Consultant OtherNAME OF EMPLOYER (Type of Business):
FIELD OF WORK:
14.c - PREVIOUS POSTFROM(mm/yyyy) /
TO(mm/yyyy) /
EXACT TITLE OF YOUR POST:
EMPLOYMENT TYPE:
Permanent Temporary Consultant OtherNAME OF EMPLOYER (Type of Business):
FIELD OF WORK:
14.d - PREVIOUS POSTFROM(mm/yyyy) /
TO(mm/yyyy) /
EXACT TITLE OF YOUR POST:
EMPLOYMENT TYPE:
Permanent Temporary Consultant OtherNAME OF EMPLOYER (Type of Business):
FIELD OF WORK:
14.e OTHERS and/or additional work experiences
Application FormSummer Course on Migration and Human Rights 2020
3-5
E. ADDITIONAL INFORMATION
15. How did you first hear about the Summer Course?
You can tick a maximum of three options
UNICRI website
John Cabot University website
UNICRI Social Networks
John Cabot University Social Networks
UNICRI alumni
John Cabot students/alumni
UNICRI emailing
On-line (please specify):
Others (please specify):
16. Other relevant information you would like to include. For example, information regarding any professional societies, relevant experience abroad, disability and/or special need.
17. Have you ever been arrested, indicted or summoned into court as a defendant in a criminal proceeding, or convicted, fined or imprisoned for the violation of any law (excluding minor traffic violation)?
YES: NO:
If “yes”, give full particulars of each case in an attached statement:
F. VISA REQUIREMENTS
Please note that the VISA process may take up to 30 days. Those applicants requiring a VISA are encouraged to apply in accordance with early bird deadlines.
The following information will be used by the UNICRI Administrative Office in order to provide enrolled participants with an acceptance letter. This will occur only after official confirmation of acceptance and receipt of registration fees.
We encourage selected participants to contact the competent Italian Embassy/Consulate to obtain detailed information on the VISA procedure and documents needed. Please note that it is sole responsibility of the course participants to request and obtain the VISA.
18. Do you require a VISA in order to enter Italy? YES: NO:
If answer is YES, give the following information
19. Full name as it appears in the Passport
20. Passport number
21. Passport expiration date (dd/mm/yyyy) / /
22. To which Embassy/Consulate you will be applying for the VISA? (Give full details)
G. ACCOMMODATION at John Cabot University
Accommodation details: Double room in shared apartment – 7-night accommodation at the John Cabot University's Lungara Apartments. Check-in: Friday 10 July 2020 from 9.00am to 6.00pm (please read carefully #27) Check-out: Friday 17 July 2020 from 8.00am to 6.00pm (please read carefully #27) Accommodation Fees: 250 Euro per person
Deadlines: Accommodation Application Deadline: 31 May 2020 Accommodation Payment Deadline: 15 June 2020
Please note that refund of accommodation fees is granted only to those participants submitting this request to JCU Housing Office by 30 June 2020. In the event of a participant cancellation after 30 June 2020 for any reason, including VISA denial and health issues, accommodation fees will not be refunded.
23. Do you wish to apply for accommodation at John Cabot University?
IMPORTANT - Accommodation Application Deadline: 31 May 2020
YES: NO:
If answer is YES, give the following information
24. Full name as it appears in the Passport/National ID
Application FormSummer Course on Migration and Human Rights 2020
4-5
25. Passport/National ID number
26. Passport/National ID expiration date (dd/mm/yyyy) / /
27. Check-in out of the time frames specified above is not permitted. Check-in on Saturday and Sunday is not permitted. On an exceptional basis check-in on Saturday will be allowed only upon request and approval. Please do not purchase any flight/train ticket before receiving the approval of the Summer Course Administrative Office. Check-out out of the time frames specified above is not permitted, and there is no option to extend the stay at the end of the programme.
By ticking this box I understand that check-in and check-out dates are not flexible.
Date: / /
H. ACKNOLEDGMENTS AND PRIVACY WAIVER
By ticking this box I certify that the statements made by me in answering the foregoing questions are true, complete and correct to the best of my knowledge and belief.
Date: / /
By ticking this box I understand that additional supporting documents (i.e. scanned copy of your passport and/or University degrees, English language certificate, as well as supervisors and/or employer’s contact details) may be requested for eventual clarifications during the selection process. Do not, however, send any supporting document until you have been asked to do so.
Date: / /
By ticking this box I understand that my data will be processed and protected according to Italian Law n. 196 of June 30, 2003 and to EC Directives n. 95/46 and 2002/58 (protection of persons and others in the processing of personal data). I may at any moment request their updating, verification or cancellation by writing an E-mail to [email protected]
Date: / /
Application FormSummer Course on Migration and Human Rights 2020
5-5