“Summer School of Archaeology – Abruzzo (Italy)” – University of Pisa – July 27th – August
24th 2014
PART I. PERSONAL INFORMATION
Please fill in all the boxes.
First Name:
Surname:
Date of birth:
Place of birth1:
Gender:
Male
Female
Citizenship:
Passport Number:
Native Language:
Other Spoken Languages:
LANGUAGE 1
LEVEL
LANGUAGE 2
LEVEL
Current Personal Address:
Mobile Phone Number2:
1
Fixed Phone Number:
Email Address3:
Other relevant information4:
1
Please insert both the name of city and also the name of the Country of birth. (For instance: Milan, Italy)
Please insert also the International Country code.
3 Please insert the address you usually consult. If you have more than one please insert all of them.
4 Specify, in summary form, the personal information considered most important (health, special diet, etc...).
2
“Summer School of Archaeology – Abruzzo (Italy)” – University of Pisa – July 27th – August
24th 2014
PART II. EDUCATION AND PROFESSIONAL EXPERIENCE
Current University5:
Current position at the University6:
If You AREN’T A COLLEGE STUDENT, please insert your qualification and and current
activities:
Previous Archaeological Field Experience7:
Previous courses on Prehistoric Archaeology and Roman Archeology or other related
courses8:
Other Relevant Experiences:
2
5Please write the complete full name of the University you are attending.
6For example: graduate or undergraduate student, PhD, researcher, ecc…
7 Specify the name of the site, responsible of the excavation, the reference institution (For instance: University of
Pisa), date and duration of the experience.
8 Specify the name of the course, the professor and the University.
“Summer School of Archaeology – Abruzzo (Italy)” – University of Pisa – July 27th – August
24th 2014
PART III. INFORMATION FOR SUMMER SCHOOL
How did you get information about the Summer school? (please cross the correct
information):
Email sent by us
Email sent by your university
Conference
Announcement
Website
Which website?
Searching on the web
Other
Which one?
Did you already participate in any other Summer School of Archaeology or
another similar experience? If so, which one?
Motivation to attend the course (optional)
PLEASE READ CAREFULLY
“Summer School of Archaeology – Abruzzo (Italy)” – University of Pisa – July 27th – August
24th 2014
I, the undersigned, hereby declare that all information provided in this application form are truthful
and accurate and that no relevant information has been left out.
By signing this form the applicant allows “Summer School of Archeology - Abruzzo (Italy)” to use all
data provided in this form for cultural purposes. These data will always be used respecting the privacy
of individual persons.
Please send this application form to the email address indirizzo sito web (da inserire) by the
established deadline together with your personal curriculum vitae.
Once you submit the application form, the staff responsible for the the summer school will promptly
disclose to the candidate, successful or the non-acceptance of the same. If the answer is positive, it
will be shown, in detail, to the candidate, the mode of payment of the registration fee, to be paid
within the deadlines specified.
Date......................................
Signature..............................................