INTERNATIONAL MOBILITY THROUGH AGREEMENTS FINALIZED TO THE RECOGNITION OF THE DOUBLE TITLE 
APPLICATION FORM YEAR 2023-2024

				Al Presidente della Scuola di Ingegneria
 Servizio Relazioni Internazionali
Scuola Ingegneria
 Via Santa Marta, 3 – 50139 Firenze

The undersigned _________________________________________  matricola nr.  ______________ 
Place of birth  ____________________________________date of birth ______________________________
email:  ______________________@stud.unifi.it   cell phone ___________________________________

pursuant to and for the purposes of the d.p.r. 445 of 28/12/2000, aware of the penal sanctions resulting from false declarations, formation and / or use of false documents as well as the forfeiture of any benefits resulting from the provision issued on the basis of false declarations

DECLARES

•	To be enrolled at  __________________ year of one the following courses: 
Master Degree Course  (DM 270/04)
	Environmental Engineering (LM-35)
    Geoengineering (LM-35)

•	to possess the requisites as described in art. 3 of the call to participate to the international mobility through agreements aimed at the recognition of the double degree
•	to undertake to regularize enrolment in the academic year 2023/2024 before departure;
•	to have an excellent knowledge of the language required by the foreign branch deriving from: (choose and option)

•	An official certification of the language ______________________level:

  B2        C1        C2/mother tongue   

Issued by (Institute / School / CLA / Other): ………………………….……………………………………………

Street ………………...………………City…………………………………………….ZIP code………………………..   

ASK
to be admitted to the selection of candidates for international mobility through agreements aimed at the recognition of the double degree at the following Institution:
   SS. CYRIL AND METHODIUS UNIVERSITY DI SKOPJE (Macedonia del Nord)
   UNIVERSITA’ DI NOVI SAD (Serbia)

	Nr. of months 		I Semester	II Semester
    _______                                       

To this end, I attach the following documentation:
1.	Learning Agreement;
2.	Equivalence forms received by teachers
3.	Self-certification with weighted average of the exams taken in the Bachelor Degree course
4.	Self-certification with weighted average of the exams taken in the Master Degree course
5.	Motivation Letter
6.	Certificate of knowledge of the language
7.	Photocopy of a valid identity document
8.	Other specify: ____________________________________________

Date: ………………………………….		Signature  ....………………………………..

Information pursuant to the personal data protection code
(Art. 13 of the legislative decree 30 June 2003, n. 196 and subsequent amendments)
The University of Florence will process personal data also with the aid of IT tools, exclusively for the purposes of the procedure in question and to a relevant extent, not excessive and strictly necessary for the pursuit of its institutional functions.
Communication and dissemination of personal data
Pursuant to Article 11 of the Implementing Regulation of the personal data protection code held by the University of Florence and without prejudice to the right to object for reasons of legitimacy pursuant to art. 7 of Legislative Decree 30/06/2003, n.196, authorizes the communication and dissemination of my personal data in the possession of the University to public or private entities that request it in order to facilitate orientation, training and the professional and work placement, even abroad, of young students.

YES    NO 

Date: ………………………………….		Signature        ………………………………