2ND IRCVM INTERNATIONAL SCHOOL
MEDIEVAL ARCHAEOLOGICAL FIELDWORK IN THE CATALAN PYRENEES
Summer 2016 - Barcelona, 22th July to 5th August.
APPLICATION FORM
PERSONAL DETAILS
Surname/Family Name (as in passport):
First name/Given name (as in passport):
Title:
Mr.
Date of Birth (DD/MM/YYYY):
Nationality:
Gender:
M
Personal Email Address:
F
Address for correspondence: (street, house name…)
Institutional email address:
Telephone (incl. country code):
Mobile: (incl. country code):
City:
Postcode:
Country:
ACADEMIC INFORMATION
Current Programme of Study
Programme / Course Title:
University / Institution (Name and Address):
Qualification Sought:
BA
PERSONAL STATEMENT
Detail your motivations for taking this summer course. Explain your education, ambition and goals as well as
how they relate to the planned programme. Include information on your proposed plans after the
competition of the course and how this programme can help you. (max. 4000 characters)
SUPPORTING DOCUMENTS*
Copy of Passport
Academic Records
Brief CV
*Other Documents you want to provide to assess your eligibility (please specify which documents and why):
APPLICANTS DECLARATIONS
To the best of my knowledge, the information and the documents attached to this application are accurate
and complete. My application is only valid if all required information is provided and all the required
supporting documents are enclosed.
I agree to hire a health insurance or, if citizen of the European Union, to request the European Health
Insurance Card.
I agree to pay, if selected for the course, no latter than 20 days after the notification, the required fees and to
send the registration documents.
The documents attached are intended solely for the use of the organization to whom they are addressed, in
order to complete the registration for the course and assess the eligibility of the candidates. Any of the
documents or information provided will be used for marketing purposes, unless the participant explicitly
demands to be part of the Institute for Research on Medieval Cultures mailing list.
Signature:
Date: