APPLICATION FORM – A FORMAT OGS (ISTITUTO NAZIONALE DI OCEANOGRAFIA E DI GEOFISICA SPERIMENTALE) Direzione per la Gestione delle Risorse Umane Ufficio gestione giuridica amministrativa del Personale Borgo Grotta Gigante 42/c 34010 Sgonico (TS) Italy ADVISE OF PUBLIC SELECTION BASED ON QUALIFICATIONS AND INTERVIEW FOR NO. 1 RESEARCH FELLOWSHIP PROFESSIONALIZING IN THE FIELD OF “SIMULATIONS OF BEHAVIORS, RESPONSES, AND ADAPTIVE AND EVOLUTIVE CHARACTERISTICS (“TRAITS”) OF MARINE ECOSYSTEMS” BY THE SCIENTIFIC RESEARCH DIVISION OCEANOGRAPHY – OCE. (General Director Decree n. 186/2015 dd. 17/07/2015) Deadline 25TH August 2015 The undersigned Surname_____________________________________________________________________ Name_____________________________________________________________________ born in______________________________________________________ Prov. _________ foreign citizens should also give the Country of birth _______________________________________________ on the ________________(day/month/year) resident in (town, street and number) _________________________________________________________________________________ post code ____________Province ______ foreign country if applicable ________________________ nationality_________________________________________________________________________ CF/tax code______________________________________________________________________ Tel. /ph. Number ___________________________________________________________________ email_____________________________________________________________________________ Videoconference account ____________________________________________________________ REQUEST to participate in the selection and, for this purpose, aware that false declarations are punished penally pursuant to art. 76 of the Presidential Decree n. 455 of 28 December 2000, and that the OGS Administration will carry out checks, including random checks, on the truthfulness of the declarations made by the candidates DECLARES Pagina 1 di 2 Under his/her own responsibility, in accordance with arts. 46-47 of DPR 445/2000 (please mark the points owned) : □ to have a degree in: _________________________________________________________________________________ □ PhD title in _________________________________________________________________________________ awarded _________________________________________________________________________________ title of thesis _________________________________________________________________________________ □ to be in possession of all requirements indicating in art. 2 of the selection call and to be aware of all the foreseen limitations and not to fall into any of the incompatibility categories outlined in art. 7 of this Selection Call; □ to have a professional-scientific CV demonstrating skills and ability to conduct the study program. The CV has to correspond to the facts; □ to attach: - professional – scientific curriculum vitae (the CV must be undersigned) - list of the scientific publications - list of additional certificate or any other qualification that helps demonstrate their merit (the list of qualifications and publications must be signed by the applicant); - Short project description (max 2000 words): scientific excellence o scientific goals o innovative aspects o research methodology o training goals impact o expected results o impact on candidate’s career o impact on the hosting institution and on networking capacity of the project - a copy of ID card or other form of identification; □ to wish to receive the information, not published on website of OGS, at the following address _________________________________________________________________________________ Signature, place and date _________________________________________________________________________________ DECLARES Under his/her own responsibility, that the attached documents are in accordance with arts. 46-47 of DPR 445/2000 The undersigned ask that all documentation elapsed law terms being: □ returned via postal mail on delivery to the holder; □ returned directly to the person who will personally collect it within six months after the conclusion of the selection (course in vain that period, the documents will be destroyed anyway); □ destroyed Signature, place and date _________________________________________________________________________________ Pagina 2 di 2