APPLICATION FORM										ANNEX 1

To the Director
INAF-Osservatorio Astrofisico di Catania
Via S. Sofia, 78
95123 Catania, Italy

I , the undersigned (Forename(s))......................................... (Surname)...........................................................
Place of birth (Town/State)...........................................................................................
Date of birth (dd/mm/yy) ....................
Permanent residence address (number/street/town/postal code/Country): ………………..

Hereby apply  to participate to the selection for the appointment of one research grant entitled: “Support to the preparation, acquisition, and processing of IBIS observations within the SOLARNET project.” D.D. 64/14

Under my own responsibility I declare:
a) my nationality is: .............................;
b) to enjoy civil and political rights of the State of which she/he holds citizenship;
c) not to have been in the past or not to be at present under any penal sentence (if liable, please specify) ...................................................;
d) that I hold the following educational qualifications (decree, PHD) ………………………………,
awarded by………………………………………………………, Date………………………….;
or
that I have ……. years of documented experience in scientific or technological activities at………………………………………………………………………………………………......................(list research grants and/or fellowships hold in the past ,length and host Institution):
f) to be presently holding the following research grant or fellowship (length and host Institution): ……………………………………..

The following documents are attached:
1. curriculum vitae et studiorum, in which also past research grants or fellowships are listed;
2. list of publications available on the web;
3. any work or publications which is not available on the web which might be useful for qualifying the scientific curriculum;
4. foreign citizens are requested to attach copy of the University degree/academic qualification certificate inclusive of the list of individual exams and the final score, or copy of the equivalent foreign degree certificate, and copy of the PhD certificate or of the equivalent foreign academic qualification;
5. self-declaration (Annex 2).

The undersigned authorizes the Administrative Office of INAF-Osservatorio Astrofisico di Catania to process her/his personal data only for the purpose of the present selection.
The undersigned wishes to receive communications concerning the selection at the
following address (number/street/town/postal code/State): ………………………………
(if possible list also phone number, fax number and e-mail address): ................................

Place and date (dd/mm/yy)
						(Applicant’s signature, not to be authenticated)

											ANNEX 2

SELF-CERTIFICATION
The undersigned (Forename(s))....................... (Surname)....................................
Place of birth (Town/State) ..................................
Date of birth (dd/mm/yy) ....................
Permanent residence address (number/street/town/postal code/Country) ……………..,
As candidate to the selection for one research grant issued by INAF-Osservatorio
Astrofisico di Catania with Director’s Decree n. 66/14, aware that producing false
statements and forged documents, as well as the use of forged documents shall be punished
in accordance with the Criminal Code and with any other applicable special acts on this
matter,

DECLARES AND SELF-CERTIFIES

1) that submitted copies of academic theses and dissertations, of publications and works
are conformal copies of the original documents;
2) to hold the following degree in: (discipline) ………………………
Date of award: (dd/mm/yy)………………………………………….
Awarding University: …………………………………. Final mark: …………………
3) to hold the following academic qualifications:
PhD degree in: (discipline) …………………………
Date of award: (dd/mm/yy)…………… Awarding University:……………………
Final mark: ………………..
Certificates of attendance to post-degree courses: ………………………..
Fellowships: …………………………………….
Research contracts/grants at private and/or public institutions: ……………………..
Other:.............................................................................................................

Place and date (dd/mm/yy)

									(full applicant’s signature)

									_____________________________

N.B. A photocopy, not authenticated, of a valid identity document of the applicant must be
attached.

											ALLEGATO 2 (IT)
FAC-SIMILE
⃞ DICHIARAZIONI SOSTITUTIVE DI CERTIFICAZIONI
(Art.. 46 D.P.R. n. 445/2000)
⃞ DICHIARAZIONI SOSTITUTIVE DELL’ATTO DI NOTORIETÀ
(in tal caso allegare fotocopia di un valido documento d’identità)
(Art.. 47 D.P.R. n. 445/2000)
barrare accanto alla dichiarazione che interessa
Il sottoscritto:
COGNOME……………………….……………………(per le donne indicare il cognome da nubile)
NOME……………………………………CODICE FISCALE …………………………….……….
NATO A…………………………………....(PROVINCIA ……) IL………………SESSO ……
ATTUALMENTE RESIDENTE A………………………………………….(PROVINCIA …….)
INDIRIZZO……………………………………………………………………C.A.P.…………..
TELEFONO…………... ……….……………………………………,
consapevole che le dichiarazioni mendaci sono punite ai sensi dell’art. 76 del DPR 445/2000
DICHIARA:
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
Dichiara altresì di essere informato, ai sensi e per gli effetti di cui al decreto legislativo 196/2003, che i dati personali raccolti saranno trattati, anche con strumenti informatici, esclusivamente nell’ambito del procedimento per il quale la presente viene resa.
Luogo e data…………….. 
						        Il dichiarante
……………………………………