SWISS EUROPEAN MOBILITY PROGRAMME YEAR 2026-2027
APPLICATION FORM

				To the President of the School of Engineering
 Servizio Relazioni Internazionali
Scuola Ingegneria
 Via Santa Marta, 3 – 50139 Firenze

The undersigned _________________________________________  matricola nr.  ______________ 
Place of birth  ____________________________________date of birth ______________________________
email:  ______________________@edu.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 the study course __________________________________ 
•	to possess the requisites as described in art. 3 of the call to participate in the Swiss European Mobility Program (SEMP);
•	to undertake to regularize enrolment in the academic year 2026/2027 before departure;
•	to have an excellent knowledge of the language required by the foreign branch deriving from: (choose an option)
•	A certification of the language ______________________level:

	 A1     A2     B1     B2   C1/madrelingua    C2 

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

•	An additional certification of the language ______________________level:

 	 A1     A2     B1     B2   C1/madrelingua    C2 

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

ASK
to be admitted to the selection of candidates for the SEMP Mobility Call year 2026/2027 for the following Host Institution:
	I Sem		II Sem
First Choice: __________________________________                                       

Second Choice: __________________________________                                  

To this end, I attach the following documentation:
1.	Learning Agreement
2.	Equivalence forms received from the reference teachers relating to the exams selected at the host institution (if applicable)
3.	Self-certification of the list of exams with grades, that the candidate has taken both in Bachelor and Master Degree study courses 
4.	A motivational letter to the mobility
5.	Copy of a valid Identity Card/Passport
6.	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        ………………………………